OP215: Radiation induced sarcomas of the head and neck

Abstract

For over a century, ionising radiation has been known to induce malignancies in almost every organ, the most common being leukaemias and sarcomas. Radiation-induced sarcomas of the head and neck are rare tumours which present multiple resective and reconstructive challenges to the head and neck surgeon. We present our 12 year single-institution series of 17 radiation-induced sarcomas of the head and neck and compare their behaviour and outcomes to our series of 130 non-radiation induced head and neck sarcomas. Aim To compare the clinical, radiologic, pathologic characteristics and treatment outcomes of our series of 17 radiation-induced sarcomas of the head and neck with our cohort of 130 non-radiation induced head and neck sarcomas. Method We performed a retrospective study from the University College London Hospital Head and Neck Sarcoma Database of our 17 radiation-induced head and neck sarcomas over 2000–2012 including demographics, radiation characteristics, clinical and radiologic presentation, resective and reconstructive experience and treatment outcomes. Results and Conclusions Our series of radiation-induced head and neck sarcomas all had radiation doses of >40 Gy, a variable latency period and almost universally were high-grade sarcomas. Our treatment protocol consisted of neo-adjuvant chemotherapy and aggressive surgical resection with our series of radiation-induced sarcomas showing similar rates of clear surgical margins but reduced survival outcomes in comparison to non radiation-induced head and neck sarcomas.