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- Title
Radiation-Induced Oropharyngeal Squamous Cell Carcinoma: Case Report and Review of the Literature.
- Authors
Giannini, Lorenzo; Alliata, Andrea; Cristofaro, Valentina; Incandela, Fabiola; Pompilio, Madia; Ottini, Arianna; Cavalieri, Stefano; Nuzzolese, Imperia; Iacovelli, Nicola Alessandro; Franceschini, Marzia; Deganello, Alberto
- Abstract
Background: Radiation therapy (RT) is a mainstay for the treatment of head and neck (HN) cancers, with 80% of patients receiving such treatment. Radiation-induced malignancies represent a life-threatening long-term effect of RT, with an incidence of 0.5% to 15%. Case Description: After 13 years, a 33-year-old woman treated with chemo-radiotherapy for nasopharyngeal carcinoma developed a locally advanced, radiation-induced, p16-negative oropharyngeal squamous cell carcinoma (SCC) at the base of the tongue. Chemo/immunotherapy was administered as a first-line treatment. Given the optimal response and the feasibility of surgery, after three cycles, the patient underwent a total glossectomy, bilateral neck dissection, and reconstruction with a thoraco-dorsal free flap. A histological examination found SCC with a residual cancer burden of 70% and free margins. Discussion: The mechanisms responsible for carcinogenesis after RT are still not completely clear. Diagnosis may be challenging due to the previous treatment; growth patterns are unusual, and lymphotropism is lower. Prognosis is usually poor since surgical resectability is often not achievable. Conclusions: Radiation-induced malignancies are difficult to treat. Patient management should always be discussed at a multidisciplinary level. Future research is needed to assess whether the promising results of clinical studies with pre-operative immunotherapy in locally advanced HN SCC patients may be translated into radiation-induced cancers.
- Subjects
LITERATURE reviews; RADIOTHERAPY; SQUAMOUS cell carcinoma; FREE flaps; NECK dissection; RADIATION carcinogenesis; HEAD &; neck cancer; NASOPHARYNX cancer; TONGUE cancer
- Publication
Current Oncology, 2023, Vol 30, Issue 7, p6708
- ISSN
1198-0052
- Publication type
Article
- DOI
10.3390/curroncol30070492