Radiation-Induced Sarcomas of the Head and Neck: A Systematic Review

• Authors: Andres Coca-Pelaz, University of Oviedo; Antti A. Makitie, University of Helsinki; Primoz Strojan, University of Ljubljana; June Corry, University of Melbourne; Avraham Eisbruch, University of Michigan; Jonathan Beitler, Emory University; Sandra Nuyts, University of Leuven; Robert Smee, Prince Wales Cancer Centre; Johannes A. Langendijk, University Medical Center Groningen; William M Mendenhall, University of Florida; Cesare Piazza, Fondazione IRCCS Istituto Nazionale dei Tumori; Alessandra Rinaldo, University of Udine; Alfio Ferlito, International Head and Neck Scientific Group
• Journal Title: ADVANCES IN THERAPY
• Volume: Volume 38, Number 1
• Publisher: SPRINGER | 2020-11-13, Pages 90-108
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1007/s12325-020-01556-y
• Subjects: Chemistry, Radiation; Health Sciences, Oncology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Medicine, Research & Experimental; Pharmacology & Pharmacy; Research & Experimental Medicine; Head and neck; Radiation-induced; Radiotherapy; Sarcoma; Surgical treatment; MALIGNANT FIBROUS HISTIOCYTOMA; POSTIRRADIATION SARCOMA; POSTRADIATION SARCOMA; INDUCED OSTEOSARCOMA; INDUCED TUMORS; RADIOTHERAPY; THERAPY; LARYNX; RHABDOMYOSARCOMA; LEIOMYOSARCOMAS

Abstract

Introduction: As a result of the increased use of radiotherapy (RT) and improved long-term overall survival of patients with cancers of the head and neck (HN), the frequency of radiation-induced sarcomas of the head and neck (RISHN) may be increasing. The main objective of this systematic review was to determine the existing evidence on the frequency, treatment, and outcome of RISHN. Methods: Using PRISMA guidelines we conducted a systematic review of the literature published from 2000 to 2020. Results: Our review includes data of 560 patients from 64 articles. The total frequency of RISHNs among the reviewed series was 0.15%. The most frequent location of the primary tumor treated by RT was the nasopharynx. The mean RT dose used was 62 Gy, mean latency interval between irradiation and occurrence of RISHN was 11.1 years, and the most common RISHN location was the sinonasal region. Osteosarcoma was the principal histology, followed by fibrosarcoma. Surgery was the most frequently applied treatment modality. Of all patients with RISHN, 40.7% died of this disease after a mean interval of 13.9 months. Conclusions: Notwithstanding the increased use of RT, the number of reported RISHNs has not increased substantially during the past two decades. Surgery with wide margins forms the best therapeutic option for these cases, but the outcome remains poor.