Radiation-induced Secondary Malignancies for Nasopharyngeal Carcinoma: a Pilot Study of Patients Treated Via IMRT or VMAT

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2018 Feb 7

PMID 29403311

Citations 14

Authors

Hsiao-Fei Lee

Jen-Hong Lan

Pei-Ju Chao

Hui-Min Ting

Hui-Chun Chen

Hsuan-Chih Hsu

Tsair-Fwu Lee

Affiliations

Soon will be listed here.

Abstract

Background: Patients treated with radiotherapy are at risk of developing a second cancer during their lifetime, which can directly impact treatment decision-making and patient management. The aim of this study was to qualify and compare the secondary cancer risk (SCR) after intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in nasopharyngeal carcinoma (NPC) patients.

Patients And Methods: We analyzed the treatment plans of a cohort of 10 NPC patients originally treated with IMRT or VMAT. Dose distributions in these plans were used to calculate the organ equivalent dose (OED) with Schneider's full model. Analyses were applied to the brain stem, spinal cord, oral cavity, pharynx, parotid glands, lung, mandible, healthy tissue, and planning target volume.

Results: We observed that the OED-based risks of SCR were slightly higher for the oral cavity and mandible when VMAT was used. No significant difference was found in terms of the doses to other organs, including the brain stem, parotids, pharynx, submandibular gland, lung, spinal cord, and healthy tissue. In the NPC cohort, the lungs were the organs that were most sensitive to radiation-induced cancer.

Conclusion: VMAT afforded superior results in terms of organ-at-risk-sparing compared with IMRT. Most OED-based second cancer risks for various organs were similar when VMAT and IMRT were employed, but the risks for the oral cavity and mandible were slightly higher when VMAT was used.

Citing Articles

Diabetes and two kinds of primary tumors in a patient with thalassemia: a case report and literature review.

Yu X, Peng Y, Nie T, Sun W, Zhou Y Front Oncol. 2023; 13:1207336.

PMID: 37637036 PMC: 10455928. DOI: 10.3389/fonc.2023.1207336.

Secondary Sinonasal Collision Tumor of Papillary Squamous Cell Carcinoma and Small Cell Neuroendocrine Carcinoma After Nasopharyngeal Carcinoma Radiotherapy: A Case Report and Literature Review of Sinonasal Collision Carcinomas.

Tang H, Wang L, Xu W, Xu Y, Li X, Guo D Onco Targets Ther. 2023; 16:91-97.

PMID: 36817507 PMC: 9930577. DOI: 10.2147/OTT.S396703.

Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy.

Wang W, Li M, Pan X J Cancer. 2022; 13(13):3452-3462.

PMID: 36313032 PMC: 9608213. DOI: 10.7150/jca.77768.

Secondary Oral Cancer after Systemic Treatment of Hematological Malignancies and Oral GVHD: A Systematic Review.

Janowiak-Majeranowska A, Osowski J, Mikaszewski B, Majeranowski A Cancers (Basel). 2022; 14(9).

PMID: 35565303 PMC: 9102759. DOI: 10.3390/cancers14092175.

Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy.

Kang D, Shin Y, Jeong S, Jung J, Lee H, Lee B Radiat Oncol. 2021; 16(1):108.

PMID: 34118968 PMC: 8199704. DOI: 10.1186/s13014-020-01722-0.

References

Harbron R, Feltbower R, Glaser A, Lilley J, Pearce M . Secondary malignant neoplasms following radiotherapy for primary cancer in children and young adults. Pediatr Hematol Oncol. 2013; 31(3):259-67. DOI: 10.3109/08880018.2013.838723. View

Kellerer A, Nekolla E, Walsh L . On the conversion of solid cancer excess relative risk into lifetime attributable risk. Radiat Environ Biophys. 2002; 40(4):249-57. DOI: 10.1007/s004110100106. View

Taylor C, Correa C, Duane F, Aznar M, Anderson S, Bergh J . Estimating the Risks of Breast Cancer Radiotherapy: Evidence From Modern Radiation Doses to the Lungs and Heart and From Previous Randomized Trials. J Clin Oncol. 2017; 35(15):1641-1649. PMC: 5548226. DOI: 10.1200/JCO.2016.72.0722. View

Zhu W, Hu F, Zhao T, Wang C, Tao Q . Clinical Characteristics of Radiation-Induced Sarcoma of the Head and Neck: Review of 15 Cases and 323 Cases in the Literature. J Oral Maxillofac Surg. 2015; 74(2):283-91. DOI: 10.1016/j.joms.2015.07.013. View

Berrington de Gonzalez A, Gilbert E, Curtis R, Inskip P, Kleinerman R, Morton L . Second solid cancers after radiation therapy: a systematic review of the epidemiologic studies of the radiation dose-response relationship. Int J Radiat Oncol Biol Phys. 2012; 86(2):224-33. PMC: 3816386. DOI: 10.1016/j.ijrobp.2012.09.001. View

Thiagarajan A, Iyer N . Radiation-induced sarcomas of the head and neck. World J Clin Oncol. 2014; 5(5):973-81. PMC: 4259957. DOI: 10.5306/wjco.v5.i5.973. View

Diallo I, Haddy N, Adjadj E, Samand A, Quiniou E, Chavaudra J . Frequency distribution of second solid cancer locations in relation to the irradiated volume among 115 patients treated for childhood cancer. Int J Radiat Oncol Biol Phys. 2009; 74(3):876-83. DOI: 10.1016/j.ijrobp.2009.01.040. View

Stokkevag C, Engeseth G, Ytre-Hauge K, Rohrich D, Odland O, Muren L . Estimated risk of radiation-induced cancer following paediatric cranio-spinal irradiation with electron, photon and proton therapy. Acta Oncol. 2014; 53(8):1048-57. DOI: 10.3109/0284186X.2014.928420. View

Chan J, To V, Wong S, Wei W . Radiation-induced squamous cell carcinoma of the nasopharynx after radiotherapy for nasopharyngeal carcinoma. Head Neck. 2013; 36(6):772-5. DOI: 10.1002/hed.23363. View

10.

Preston D, Ron E, Tokuoka S, Funamoto S, Nishi N, Soda M . Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat Res. 2007; 168(1):1-64. DOI: 10.1667/RR0763.1. View

11.

Schneider U . Modeling the risk of secondary malignancies after radiotherapy. Genes (Basel). 2014; 2(4):1033-49. PMC: 3927608. DOI: 10.3390/genes2041033. View

12.

Moteabbed M, Yock T, Paganetti H . The risk of radiation-induced second cancers in the high to medium dose region: a comparison between passive and scanned proton therapy, IMRT and VMAT for pediatric patients with brain tumors. Phys Med Biol. 2014; 59(12):2883-99. DOI: 10.1088/0031-9155/59/12/2883. View

13.

Lee T, Ting H, Chao P, Fang F . Dual arc volumetric-modulated arc radiotherapy (VMAT) of nasopharyngeal carcinomas: a simultaneous integrated boost treatment plan comparison with intensity-modulated radiotherapies and single arc VMAT. Clin Oncol (R Coll Radiol). 2011; 24(3):196-207. DOI: 10.1016/j.clon.2011.06.006. View

14.

Murray L, Thompson C, Lilley J, Cosgrove V, Franks K, Sebag-Montefiore D . Radiation-induced second primary cancer risks from modern external beam radiotherapy for early prostate cancer: impact of stereotactic ablative radiotherapy (SABR), volumetric modulated arc therapy (VMAT) and flattening filter free (FFF) radiotherapy. Phys Med Biol. 2015; 60(3):1237-57. DOI: 10.1088/0031-9155/60/3/1237. View

15.

Schneider U . Mechanistic model of radiation-induced cancer after fractionated radiotherapy using the linear-quadratic formula. Med Phys. 2009; 36(4):1138-43. DOI: 10.1118/1.3089792. View

16.

Schneider U, Zwahlen D, Ross D, Kaser-Hotz B . Estimation of radiation-induced cancer from three-dimensional dose distributions: Concept of organ equivalent dose. Int J Radiat Oncol Biol Phys. 2005; 61(5):1510-5. DOI: 10.1016/j.ijrobp.2004.12.040. View

17.

Kim D, Chung K, Chung W, Bae S, Shin D, Hong S . Risk of secondary cancers from scattered radiation during intensity-modulated radiotherapies for hepatocellular carcinoma. Radiat Oncol. 2014; 9:109. PMC: 4030012. DOI: 10.1186/1748-717X-9-109. View

18.

Yoon M, Shin D, Kim J, Kim J, Kim D, Park S . Craniospinal irradiation techniques: a dosimetric comparison of proton beams with standard and advanced photon radiotherapy. Int J Radiat Oncol Biol Phys. 2010; 81(3):637-46. DOI: 10.1016/j.ijrobp.2010.06.039. View

19.

Schneider U, Walsh L . Cancer risk estimates from the combined Japanese A-bomb and Hodgkin cohorts for doses relevant to radiotherapy. Radiat Environ Biophys. 2007; 47(2):253-63. DOI: 10.1007/s00411-007-0151-y. View

20.

Paganetti H, Athar B, Moteabbed M, Adams J, Schneider U, Yock T . Assessment of radiation-induced second cancer risks in proton therapy and IMRT for organs inside the primary radiation field. Phys Med Biol. 2012; 57(19):6047-61. DOI: 10.1088/0031-9155/57/19/6047. View