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The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis
To investigate the clinical characteristics associated with the risk of developing secondary primary tumors (SPTs) in patients with nasopharyngeal carcinoma (NPC) who underwent intensity-modulated radiotherapy (IMRT). Data from 527 patients with biopsy-proven nonmetastatic NPC who were treated with...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106069/ https://www.ncbi.nlm.nih.gov/pubmed/27828863 http://dx.doi.org/10.1097/MD.0000000000005364 |
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author | Zhao, Wei Lei, Hao Zhu, Xiaodong Li, Ling Qu, Song Liang, Xia Wang, Xiao |
author_facet | Zhao, Wei Lei, Hao Zhu, Xiaodong Li, Ling Qu, Song Liang, Xia Wang, Xiao |
author_sort | Zhao, Wei |
collection | PubMed |
description | To investigate the clinical characteristics associated with the risk of developing secondary primary tumors (SPTs) in patients with nasopharyngeal carcinoma (NPC) who underwent intensity-modulated radiotherapy (IMRT). Data from 527 patients with biopsy-proven nonmetastatic NPC who were treated with IMRT between January 2007 and December 2011 were analyzed retrospectively. The cumulative incidence of SPTs after IMRT completion was estimated using the Kaplan–Meier method. Intergroup differences in the cumulative incidence were determined using the log-rank test. The Cox proportional hazards regression model was used to confirm the risk factors associated with IMRT-induced SPTs. The median follow-up duration was 45.5 months (range, 4–97 months). Of the 527 patients, 12 (2.3%) developed posttreatment SPTs (9 men, 3 women), 6 of which were located in the irradiation field. SPTs were mostly located in the upper aerodigestive tract (n = 7), head and neck (n = 6), lungs (n = 3), and tongue (n = 2). The 1-, 3-, and 5-year cumulative SPT risk rates were 0.4%, 1.4%, and 3.1%, respectively, and the mean annual growth in cumulative incidence was approximately 0.6%. The 1-, 3-, and 5-year cumulative in-field SPT risk rates were 0.4%, 0.8%, and 1.5%, respectively, and the mean annual growth in the in-field cumulative incidence was approximately 0.3%. Univariate and multivariate analysis revealed that sex, age, clinical stage, chemotherapy, and overall IMRT duration did not significantly affect SPT risk. However, the history of smoking was the independent risk factor associated with SPT. The 5-year SPT incidence among patients with NPC after IMRT is concordant with or lower than that in previous 2-dimensional radiotherapy studies study. Among patients with NPC who underwent IMRT, the upper aerodigestive tract was the most common SPT site, and lung cancer was the most common pathology. Smoking history, but not sex, age, clinical stage, chemotherapy, and overall IMRT duration is the independent risk factor associated with SPT. Additional large-scale studies with longer-term follow-ups are needed to determine risk factors associated with SPT development after IMRT. |
format | Online Article Text |
id | pubmed-5106069 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-51060692016-11-16 The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis Zhao, Wei Lei, Hao Zhu, Xiaodong Li, Ling Qu, Song Liang, Xia Wang, Xiao Medicine (Baltimore) 5700 To investigate the clinical characteristics associated with the risk of developing secondary primary tumors (SPTs) in patients with nasopharyngeal carcinoma (NPC) who underwent intensity-modulated radiotherapy (IMRT). Data from 527 patients with biopsy-proven nonmetastatic NPC who were treated with IMRT between January 2007 and December 2011 were analyzed retrospectively. The cumulative incidence of SPTs after IMRT completion was estimated using the Kaplan–Meier method. Intergroup differences in the cumulative incidence were determined using the log-rank test. The Cox proportional hazards regression model was used to confirm the risk factors associated with IMRT-induced SPTs. The median follow-up duration was 45.5 months (range, 4–97 months). Of the 527 patients, 12 (2.3%) developed posttreatment SPTs (9 men, 3 women), 6 of which were located in the irradiation field. SPTs were mostly located in the upper aerodigestive tract (n = 7), head and neck (n = 6), lungs (n = 3), and tongue (n = 2). The 1-, 3-, and 5-year cumulative SPT risk rates were 0.4%, 1.4%, and 3.1%, respectively, and the mean annual growth in cumulative incidence was approximately 0.6%. The 1-, 3-, and 5-year cumulative in-field SPT risk rates were 0.4%, 0.8%, and 1.5%, respectively, and the mean annual growth in the in-field cumulative incidence was approximately 0.3%. Univariate and multivariate analysis revealed that sex, age, clinical stage, chemotherapy, and overall IMRT duration did not significantly affect SPT risk. However, the history of smoking was the independent risk factor associated with SPT. The 5-year SPT incidence among patients with NPC after IMRT is concordant with or lower than that in previous 2-dimensional radiotherapy studies study. Among patients with NPC who underwent IMRT, the upper aerodigestive tract was the most common SPT site, and lung cancer was the most common pathology. Smoking history, but not sex, age, clinical stage, chemotherapy, and overall IMRT duration is the independent risk factor associated with SPT. Additional large-scale studies with longer-term follow-ups are needed to determine risk factors associated with SPT development after IMRT. Wolters Kluwer Health 2016-11-11 /pmc/articles/PMC5106069/ /pubmed/27828863 http://dx.doi.org/10.1097/MD.0000000000005364 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 5700 Zhao, Wei Lei, Hao Zhu, Xiaodong Li, Ling Qu, Song Liang, Xia Wang, Xiao The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis |
title | The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis |
title_full | The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis |
title_fullStr | The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis |
title_full_unstemmed | The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis |
title_short | The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis |
title_sort | clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: a retrospective analysis |
topic | 5700 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106069/ https://www.ncbi.nlm.nih.gov/pubmed/27828863 http://dx.doi.org/10.1097/MD.0000000000005364 |
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