舌鳞状细胞癌放疗后骨肉瘤1例报告及文献复习

doi:10.19438/j.cjoms.2018.06.016

摘要/Abstract

摘要： 放疗诱发肉瘤（radiation induced sarcoma,RIS）是放射治疗后一种少见而严重的并发症,在全身多个部位的原发肿瘤放疗后均有报道,其恶性程度高,预后差,在临床诊断及治疗上均有极大难度。本文报告1例舌鳞状细胞癌放疗后诱发下颌骨骨肉瘤,同时伴发舌、口底第二原发癌的患者,并结合国内外文献,对头颈部放疗诱发肉瘤（radiation-induced sarcoma of head and neck,RISHN）的发病因素、诊断标准、临床特点、治疗及预后进行讨论。

关键词: 鳞状细胞癌, 放疗诱发肉瘤, 第二原发癌

Abstract: Radiation induced sarcoma (RIS), which is a rare, serious and highly malignant complication of cancer radiation therapy, has been documented in a series of primary cancers from different parts of the body. Due to the difficulty in diagnosis and therapeutic management, the prognosis is still poor. Herein, we reported a case of radiation-induced osteosarcoma and second primary tumors (SPTs) in a patient with tongue squamous cell carcinomas and reviewed relevant literatures. The epidemic factors, diagnostic criteria, clinical manifestation, treatment and prognosis of radiation-induced sarcoma of head and neck (RISHN) were discussed.

Key words: Squamous cell carcinomas, Radiation induced sarcoma, Second primary tumors

中图分类号:

R739.8

缪帆, 余自力, 刘克, 赵怡芳. 舌鳞状细胞癌放疗后骨肉瘤1例报告及文献复习[J]. 中国口腔颌面外科杂志, 2018, 16(6): 572-576.

MIAO Fan, YU Zi-li, LIU Ke, ZHAO Yi-fang. Radiation-induced osteosarcoma in patient with tongue squamous cell carcinomas: a case report and review of the literature[J]. China J Oral Maxillofac Surg, 2018, 16(6): 572-576.

参考文献

[1] Sholl LM, Barletta JA, Hornick JL.Radiation-associated neoplasia: clinical, pathological and genomic correlates[J]. Histopathology, 2017, 70(1): 70-80.
[2] Brady MS, Gaynor JJ, Brennan MF.Radiation-associated sarcoma of bone and soft tissue[J]. Arch Surg, 1992, 127(12): 1379-1385.
[3] Marchitto G, Marci V, Berrone M, et al. Early arising sarcoma after adjuvant radiotherapy for oral squamous cell carcinoma [J]. J Oral Maxillofac Surg, 2016, 74(4): 862. e1-e8.
[4] Zhang GB, Li J, Zhang PF, et al.Radiation-induced malignant fibrous histiocytoma of the occipital: a case report[J]. World J Surg Oncol, 2014, 12: 98.
[5] Aerts I, Pacquement H, Doz F, et al.Outcome of second malignancies after retinoblastoma: a retrospective analysis of 25 patients treated at the Institut Curie[J]. Eur J Cancer, 2004, 40(10): 1522-1529.
[6] 游云华, 林勇峰, 梁军, 等. 颌面部放疗后骨肉瘤27例临床分析[J]. 中国实用口腔科杂志, 2012, 5(9): 555-557.
[7] Prakash O, Varghese BT, Mathews A, et al.Radiation induced osteogenic sarcoma of the maxilla[J]. World J Surg Oncol, 2005, 3: 49.
[8] 连启星, 杨再敏, 吴求亮. 颊部血管瘤放疗后肉瘤变1例报告[J]. 口腔医学, 1981, 1(2): 92-93.
[9] Wei Z, Xie Y, Xu J, et al.Radiation-induced sarcoma of head and neck: 50 years of experience at a single institution in an endemic area of nasopharyngeal carcinoma in China[J]. Med Oncol, 2012, 29(2): 670-676.
[10] Thiagarajan A, Iyer NG.Radiation-induced sarcomas of the head and neck[J]. World J Clin Oncol, 2014, 5(5): 973-981.
[11] Kadouri L, Sagi M, Goldberg Y, et al.Genetic predisposition to radiation induced sarcoma: possible role for BRCA and p53 mutations[J]. Breast Cancer Res Treat, 2013, 140(1): 207-211.
[12] Henderson TO, Whitton J, Stovall M, et al.Secondary sarcomas in childhood cancer survivors: a report from the Childhood Cancer Survivor Study[J]. J Natl Cancer Inst, 2007, 99(4): 300-308.
[13] Virtanen A, Pukkala E, Auvinen A.Incidence of bone and soft tissue sarcoma after radiotherapy: a cohort study of 295,712 Finnish cancer patients[J]. Int J Cancer, 2006, 118(4): 1017-1021.
[14] Mark RJ, Bailet JW, Poen J, et al.Postirradiation sarcoma of the head and neck[J]. Cancer, 1993, 72(3): 887-893.
[15] Rubino C, Shamsaldin A, Lê MG, et al.Radiation dose and risk of soft tissue and bone sarcoma after breast cancer treatment[J]. Breast Cancer Res Treat, 2005, 89(3): 277-288.
[16] Wiklund TA, Blomqvist CP, Räty J, et al.Postirradiation sarcoma. Analysis of a nationwide cancer registry material[J]. Cancer, 1991, 68(3): 524-531.
[17] Xi M, Liu MZ, Wang HX, et al.Radiation-induced sarcoma in patients with nasopharyngeal carcinoma: a single-institution study[J]. Cancer, 2010, 116(23): 5479-5486.
[18] Samartzis D, Nishi N, Cologne J, et al.Ionizing radiation exposure and the development of soft-tissue sarcomas in atomic-bomb survivors[J]. J Bone Joint Surg Am, 2013, 95(3): 222-229.
[19] Cahan Wg, Woodard Hq.Sarcoma arising in irradiated bone: report of 11 cases[J]. Cancer, 1948, 1(1): 3-29.
[20] Murray EM, Werner D, Greeff EA, et al.Postradiation sarcomas: 20 cases and a literature review[J]. Int J Radiat Oncol Biol Phys, 1999, 45(4): 951-961.
[21] Gladdy RA, Qin LX, Moraco N, et al.Do radiation-associated soft tissue sarcomas have the same prognosis as sporadic soft tissue sarcomas?[J]. J Clin Oncol, 2010, 28(12): 2064-2069.
[22] Sale KA, Wallace DI, Girod DA, et al.Radiation-induced malignancy of the head and neck[J]. Otolaryngol Head Neck Surg, 2004, 131(5): 643-645.
[23] Gleber-Netto FO, Braakhuis BJ, Triantafyllou A, et al.Molecular events in relapsed oral squamous cell carcinoma: Recurrence vs. secondary primary tumor[J]. Oral Oncol, 2015, 51(8): 738-744.
[24] Wu X, Gu J, Dong Q, et al.Joint effect of mutagen sensitivity and insulin-like growth factors in predicting the risk of developing secondary primary tumors and tumor recurrence in patients with head and neck cancer[J]. Clin Cancer Res, 2006, 12(23): 7194-7201.
[25] Hong WK, Lippman SM, Itri LM, et al.Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck[J]. N Engl J Med, 1990, 323(12): 795-801.
[26] Franco Gutiérrez V, Llorente Pendás JL, Coca Pelaz A, et al.Radiation-induced sarcomas of the head and neck[J]. J Craniofac Surg, 2008, 19(5): 1287-1291.
[27] Robinson E, Neugut AI, Wylie P.Clinical aspects of postirradiation sarcomas[J]. J Natl Cancer Inst, 1988, 80(4): 233-240.
[28] Wei ZB, Xu J, Zeng XJ, et al.Radiation-induced sarcoma in the head and neck region: a clinicopathologic and immunohistochemical study of 13 cases[J]. Asian Pac J Cancer Prev, 2011, 12(11): 2995-2999.
[29] Yang Q, Mo Y, Zhao Q, et al.Radiation-induced sarcomas of the head and neck in post-radiation nasopharyngeal carcinoma[J]. Radiol Med, 2017, 122(1): 53-60.
[30] Cai PQ, Wu YP, Li L, et al.CT and MRI of radiation-induced sarcomas of the head and neck following radiotherapy for nasopharyngeal carcinoma[J]. Clin Radiol, 2013, 68(7): 683-689.
[31] Liu WW, Liang WQ, Hao WG, et al.Clinicopathologic features, treatment, and prognosis of postirradiation osteosarcoma in patients with nasopharyngeal cancer[J]. Laryngoscope, 2005, 115(9): 1574-1579.
[32] Zhu W, Hu F, Zhao T, et al.Clinical characteristics of radiation-induced sarcoma of the head and neck: review of 15 cases and 323 cases in the literature[J]. J Oral Maxillofac Surg, 2016, 74(2): 283-291.
[33] Yeang MS, Tay K, Ong WS, et al.Outcomes and prognostic factors of post-irradiation and de novo sarcomas of the head and neck: a histologically matched case-control study[J]. Ann Surg Oncol, 2013, 20(9): 3066-3075.