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Article: Second primary cancer after intensity-modulated radiotherapy for nasopharyngeal carcinoma: A territory-wide study by HKNPCSG

TitleSecond primary cancer after intensity-modulated radiotherapy for nasopharyngeal carcinoma: A territory-wide study by HKNPCSG
Authors
KeywordsIntensity-modulated radiotherapy
Nasopharyngeal carcinoma
Second primary cancer
Survival
Survivorship
Issue Date2020
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncology
Citation
Oral Oncology, 2020, v. 111, p. article no. 105012 How to Cite?
AbstractObjectives: Long-term risk of second primary cancer (SPC) after definitive intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) remains unclear. This study aims to evaluate the risk, predictive factors and survival impact of SPC in a large territory-wide cohort of NPC survivors in an endemic region. Materials and Methods: In this multicenter study, consecutive NPC patients (n = 3166) who underwent definitive IMRT in all six public oncology centers in Hong Kong between 2001 and 2010 were included. SPC risks were quantified by standardized incidence ratios (SIRs) and absolute excess risks (AERs) estimated from corresponding age-, sex-, and calendar year-specific population cancer incidence data from the Hong Kong Cancer Registry. Predictive factors and SPC-specific mortality were analyzed. Results: Over a median follow-up period of 10.8 years, 290 cases of SPC were observed with a crude incidence of 9.2%. Cancer risk in NPC survivors was 90% higher than that in general population [SIR, 1.9; 95% confidence interval (CI), 1.7–2.2], with an AER of 52.1 (95% CI, 36.8–67.3) per 10,000 person-years at risk. Significant excess cancer risks were observed for oral cavity, sarcoma, oropharynx, paranasal sinus, salivary gland, thyroid, skin and lung. Advanced age, smoking, hepatitis B status, and re-irradiation were independent predictive factors. SPC accounted for 9.4% of all deaths among NPC survivors during the study period, and 10-year SPC-specific mortality was 3.4%. Conclusions: Second cancer risk after IMRT was substantial among NPC patients. SPC impairs long-term survival, and close surveillance is warranted as part of survivorship care. © 2020 Elsevier Ltd
Persistent Identifierhttp://hdl.handle.net/10722/290548
ISSN
2019 Impact Factor: 3.979
2015 SCImago Journal Rankings: 1.764
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChow, JCH-
dc.contributor.authorTam, AHP-
dc.contributor.authorCheung, KM-
dc.contributor.authorLee, VHF-
dc.contributor.authorChiang, CL-
dc.contributor.authorTong, M-
dc.contributor.authorWong, ECY-
dc.contributor.authorCheung, AKW-
dc.contributor.authorChan, SPC-
dc.contributor.authorLai, JWY-
dc.contributor.authorNgan, RKC-
dc.contributor.authorNg, WT-
dc.contributor.authorLee, AWM-
dc.contributor.authorAu, KH-
dc.date.accessioned2020-11-02T05:43:48Z-
dc.date.available2020-11-02T05:43:48Z-
dc.date.issued2020-
dc.identifier.citationOral Oncology, 2020, v. 111, p. article no. 105012-
dc.identifier.issn1368-8375-
dc.identifier.urihttp://hdl.handle.net/10722/290548-
dc.description.abstractObjectives: Long-term risk of second primary cancer (SPC) after definitive intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) remains unclear. This study aims to evaluate the risk, predictive factors and survival impact of SPC in a large territory-wide cohort of NPC survivors in an endemic region. Materials and Methods: In this multicenter study, consecutive NPC patients (n = 3166) who underwent definitive IMRT in all six public oncology centers in Hong Kong between 2001 and 2010 were included. SPC risks were quantified by standardized incidence ratios (SIRs) and absolute excess risks (AERs) estimated from corresponding age-, sex-, and calendar year-specific population cancer incidence data from the Hong Kong Cancer Registry. Predictive factors and SPC-specific mortality were analyzed. Results: Over a median follow-up period of 10.8 years, 290 cases of SPC were observed with a crude incidence of 9.2%. Cancer risk in NPC survivors was 90% higher than that in general population [SIR, 1.9; 95% confidence interval (CI), 1.7–2.2], with an AER of 52.1 (95% CI, 36.8–67.3) per 10,000 person-years at risk. Significant excess cancer risks were observed for oral cavity, sarcoma, oropharynx, paranasal sinus, salivary gland, thyroid, skin and lung. Advanced age, smoking, hepatitis B status, and re-irradiation were independent predictive factors. SPC accounted for 9.4% of all deaths among NPC survivors during the study period, and 10-year SPC-specific mortality was 3.4%. Conclusions: Second cancer risk after IMRT was substantial among NPC patients. SPC impairs long-term survival, and close surveillance is warranted as part of survivorship care. © 2020 Elsevier Ltd-
dc.languageeng-
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncology-
dc.relation.ispartofOral Oncology-
dc.subjectIntensity-modulated radiotherapy-
dc.subjectNasopharyngeal carcinoma-
dc.subjectSecond primary cancer-
dc.subjectSurvival-
dc.subjectSurvivorship-
dc.titleSecond primary cancer after intensity-modulated radiotherapy for nasopharyngeal carcinoma: A territory-wide study by HKNPCSG-
dc.typeArticle-
dc.identifier.emailLee, VHF: vhflee@hku.hk-
dc.identifier.emailChiang, CL: chiangcl@hku.hk-
dc.identifier.emailNgan, RKC: rkcngan@hku.hk-
dc.identifier.emailNg, WT: ngwt1@hkucc.hku.hk-
dc.identifier.emailLee, AWM: awmlee@hkucc.hku.hk-
dc.identifier.authorityLee, VHF=rp00264-
dc.identifier.authorityChiang, CL=rp02241-
dc.identifier.authorityNgan, RKC=rp02371-
dc.identifier.authorityNg, WT=rp02671-
dc.identifier.authorityLee, AWM=rp02056-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.oraloncology.2020.105012-
dc.identifier.pmid32980659-
dc.identifier.scopuseid_2-s2.0-85091648734-
dc.identifier.hkuros317709-
dc.identifier.volume111-
dc.identifier.spagearticle no. 105012-
dc.identifier.epagearticle no. 105012-
dc.identifier.isiWOS:000596297600018-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1368-8375-

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