Your browser doesn't support javascript.
loading
Risk Assessment of Secondary Primary Malignancies in Nasopharyngeal Carcinoma: A Big-Data Intelligence Platform-Based Analysis of 6,377 Long-term Survivors from an Endemic Area Treated with Intensity-Modulated Radiation Therapy during 2003–2013 / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment ; : 982-991, 2019.
Article in English | WPRIM | ID: wpr-763181
ABSTRACT

PURPOSE:

The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized. METHODS AND MATERIALS Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival.

RESULTS:

Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival.

CONCLUSION:

This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Smoke / Smoking / Proportional Hazards Models / China / Incidence / Multivariate Analysis / Retrospective Studies / Risk Factors / Cohort Studies / Follow-Up Studies Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans / Male Country/Region as subject: Asia Language: English Journal: Cancer Research and Treatment Year: 2019 Type: Article

Similar

MEDLINE

...
LILACS

LIS

Full text: Available Index: WPRIM (Western Pacific) Main subject: Smoke / Smoking / Proportional Hazards Models / China / Incidence / Multivariate Analysis / Retrospective Studies / Risk Factors / Cohort Studies / Follow-Up Studies Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans / Male Country/Region as subject: Asia Language: English Journal: Cancer Research and Treatment Year: 2019 Type: Article