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01-10-2013 | Original article

Second primary malignancies in head and neck cancer patients

High prevalence of curable-stage disease

Authors: PD Dr. H.A. Wolff, M.D., C.R.M. Wolff, M.D., C.F. Hess, M.D., Ph.D., K. Jung, Ph.D., S. Sennhenn-Kirchner, M.D., M. Hinterthaner, M.D., A. Müller-Dornieden, M.D., W. Körber, M.D., K. Marten-Engelke, M.D., R. Roedel, M.D., H. Christiansen, M.D., C. Engelke, M.D.

Published in: Strahlentherapie und Onkologie | Issue 10/2013

Abstract

Background and purpose

Patients treated for squamous cell carcinoma of the head and neck (HNSCC) carry a high risk of second primary malignancies (SPM). Recently, computed tomography (CT) of the chest was shown to significantly decrease the risk of death due to bronchial carcinoma (BC) in a cohort of smokers whose risk of BC is increased but might be lower than that of patients previously treated for HNSCC. Thus, the present study evaluated the potential benefit of CT and other examinations in the detection of SPM in HNSCC patients.

Patients and methods

Between July 2008 and November 2011, 118 participants underwent a prospective, systematic examination for SPM (13 women, 105 men, median age 62 years). All patients had been previously treated for HNSCC and showed no recurrence or distant metastases at the time of the study start. CT scans, ear–nose–throat endoscopy, and endoscopy of the esophagus and stomach were performed.

Results

Overall, 33 suspicious findings were clarified by additional investigations. In all, 26 SPM were confirmed in 21 of 118 patients (18 %; 10 lung, 7 HNSCC, 3 gastrointestinal, 1 renal). Eighteen of these 21 patients (86 %) underwent therapy with curative intent.

Conclusion

The examinations revealed a high prevalence of curable stage SPM in HNSCC patients. Adapting a surveillance scheme including a chest CT is recommended.

Aberle DR, Adams AM, Berg CD et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409PubMedCrossRef

Bradley PJ, Bradley PT (2010) Searching for metachronous tumours in patients with head and neck cancer: the ideal protocol! Curr Opin Otolaryngol Head Neck Surg 18:124–133PubMedCrossRef

Chin D, Boyle GM, Porceddu S et al (2006) Head and neck cancer: past, present and future. Expert Rev Anticancer Ther 6:1111–1118PubMedCrossRef

Christiansen H, Hermann RM, Martin A et al (2006) Long-term follow-up after transoral laser microsurgery and adjuvant radiotherapy for advanced recurrent squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 65:1067–1074PubMedCrossRef

Corvo R (2007) Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiother Oncol 85:156–170PubMedCrossRef

Deantonio L, Masini L, Brambilla M et al (2013) Dysphagia after definitive radiotherapy for head and neck cancer: correlation of dose–volume parameters of the pharyngeal constrictor muscles. Strahlenther Onkol 189:230–236PubMedCrossRef

Gao Y, Hu N, Han XY et al (2011) Risk factors for esophageal and gastric cancers in Shanxi Province, China: a case–control study. Cancer Epidemiol 35:e91–e99PubMedCrossRef

Henschke CI, McCauley DI, Yankelevitz DF et al (2001) Early lung cancer action project: a summary of the findings on baseline screening. Oncologist 6:147–152PubMedCrossRef

Hernandez-Boluda JC, Pereira A, Cervantes F et al (2012) A polymorphism in the XPD gene predisposes to leukemic transformation and new nonmyeloid malignancies in essential thrombocythemia and polycythemia vera. Blood 119:5221–5228PubMedCrossRef

10.

Hess CF, Kortmann RD, Schmidberger H, Bamberg M (1994) How relevant is secondary leukaemia for initial treatment selection in Hodgkin’s disease? Eur J Cancer 30A:1441–1447PubMedCrossRef

11.

Kazi R, Manikanthan K, Pathak KA, Dwivedi RC (2010) Head and neck squamous cell cancers: need for an organised time-bound surveillance plan. Eur Arch Otorhinolaryngol 267:1969–1971PubMedCrossRef

12.

Koshy M, Rich SE, Mahmood U, Kwok Y (2012) Declining use of radiotherapy in stage I and II Hodgkin’s disease and its effect on survival and secondary malignancies. Int J Radiat Oncol Biol Phys 82:619–625PubMedCrossRef

13.

Lee KD, Lu CH, Chen PT et al (2009) The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period. BMC Cancer 9:373PubMedCrossRef

14.

Leon X, Quer M, Diez S et al (1999) Second neoplasm in patients with head and neck cancer. Head Neck 21:204–210PubMedCrossRef

15.

MacMahon H, Austin JH, Gamsu G et al (2005) Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 237:395–400PubMedCrossRef

16.

Olthoff A, Ewen A, Wolff HA et al (2009) Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer. Strahlenther Onkol 185:303–309PubMedCrossRef

17.

Pelucchi C, Tramacere I, Boffetta P et al (2011) Alcohol consumption and cancer risk. Nutr Cancer 63:983–990PubMedCrossRef

18.

Petit T, Georges C, Jung GM et al (2001) Systematic esophageal endoscopy screening in patients previously treated for head and neck squamous-cell carcinoma. Ann Oncol 12:643–646PubMedCrossRef

19.

Rades D, Meyners T, Kazic N et al (2011) Comparison of radiochemotherapy alone to surgery plus radio(chemo)therapy for non-metastatic stage III/IV squamous cell carcinoma of the head and neck: a matched-pair analysis. Strahlenther Onkol 187:541–547PubMedCrossRef

20.

Rades D, Ulbricht T, Hakim SG, Schild SE (2012) Cisplatin superior to carboplatin in adjuvant radiochemotherapy for locally advanced cancers of the oropharynx and oral cavity. Strahlenther Onkol 188:42–48PubMedCrossRef

21.

Rodel RM, Steiner W, Muller RM et al (2009) Endoscopic laser surgery of early glottic cancer: involvement of the anterior commissure. Head Neck 31:583–592PubMedCrossRef

22.

Sciubba JJ (2001) Oral cancer. The importance of early diagnosis and treatment. Am J Clin Dermatol 2:239–251PubMedCrossRef

23.

Simon C, Plinkert PK (2008) Combined modality approaches in the treatment of head and neck cancer patients. HNO 56:575–584PubMedCrossRef

24.

Swensen SJ, Jett JR, Sloan JA et al (2002) Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med 165:508–513PubMedCrossRef

25.

Tribius S, Sommer J, Prosch C et al (2013) Xerostomia after radiotherapy: what matters—mean total dose or dose to each parotid gland? Strahlenther Onkol 189:216–222PubMedCrossRef

26.

Tsou YA, Hua CH, Tseng HC et al (2007) Survival study and treatment strategy for second primary malignancies in patients with head and neck squamous cell carcinoma and nasopharyngeal carcinoma. Acta Otolaryngol 127:651–657PubMedCrossRef

27.

Weiderpass E (2010) Lifestyle and cancer risk. J Prev Med Public Health 43:459–471PubMedCrossRef

28.

Wolff HA, Bosch J, Jung K et al (2010) High-grade acute organ toxicity as positive prognostic factor in primary radio(chemo)therapy for locally advanced, inoperable head and neck cancer. Strahlenther Onkol 186:262–268PubMedCrossRef

29.

Wolff HA, Overbeck T, Roedel RM et al (2009) Toxicity of daily low dose cisplatin in radiochemotherapy for locally advanced head and neck cancer. J Cancer Res Clin Oncol 135:961–967PubMedCrossRef

Title: Second primary malignancies in head and neck cancer patients
High prevalence of curable-stage disease
Authors: PD Dr. H.A. Wolff, M.D.
C.R.M. Wolff, M.D.
C.F. Hess, M.D., Ph.D.
K. Jung, Ph.D.
S. Sennhenn-Kirchner, M.D.
M. Hinterthaner, M.D.
A. Müller-Dornieden, M.D.
W. Körber, M.D.
K. Marten-Engelke, M.D.
R. Roedel, M.D.
H. Christiansen, M.D.
C. Engelke, M.D.
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 10/2013
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-013-0404-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Second primary malignancies in head and neck cancer patients

High prevalence of curable-stage disease

Abstract

Background and purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Patients and methods

Results

Conclusion

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