The clinical features and prognosis of radiotherapy associated sarcoma (RAS) following radiotherapy for nasopharyngeal carcinoma

Abstract

To analyze the clinical features and prognosis of radiotherapy associated sarcoma (RAS) in the head and neck following radiotherapy for nasopharyngeal carcinoma (NPC). The clinicopathologic data, diagnosis, treatment and follow-up results of 11 patients with RAS diagnosed between January 1995 and December 2011 at Zhejiang Cancer Hospital were analyzed retrospectively. Among these patients, 6 were males and 5 were females. Patients' ages ranged from 33 to 66 years (median 50 years). The latency period for development of the RAS was between 3 years and 23 years (median 7 years) after irradiation. Overall survival rate was calculated using the Kaplan-Meier method and Log rank test. All cases underwent surgery, of them 6 casesachieved radical resection3 cases left with microscopic positive resection margins and 2 caseshad palliative surgery. Among 11 patients, 4 had re-surgery after recurrence, including 1 case had repeated surgeries followed by chemotherapy and radioactive seed implantation. Follow-up time ranged from 2 to 102 months, andeight patients died The 2-year, 3-year and 5-year cumulative survival rateswere 45.5%, 30.3% and 15.2%, respectively. The median survival time was 15 months. Surgical resection with clear margins achieved significantly better prognosis (P = 0.04). The incidence of RAS after radiation of NPC is generally low, but the treatment of RAS is very difficult, with poor prognosis.