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Radiation-induced tumours of the head and neck

  • B. F. A. M. van der Laan (a1), G. BARIS (a2), R. Th. Gregor (a1), F. J. M. Hilgers (a1) and A. J. M. Balm (a1)...


In order to study the induction of malignancy in normal tissues due to ionizing radiation, we reviewed the files of 2500 patients with a tumour of the head and neck treated at the Netherlands Cancer Institute (Antoni van Leeuwenhoek Ziekenhuis), Amsterdam, from 1977 to 1993. We then checked whether or not these patients had been previously irradiated. Patients with a thyroid carcinoma or skin cancer were excluded from the study, since it is generally known that previous irradiation is a risk factor in these tumours. Eighteen patients were found to have a malignancy within a previously irradiated area (0.70 per cent). The mean interval between radiation and diagnosis of the head and neck tumour was 36.5 years. There were five soft tissue sarcomas, nine squamous cell carcinomas and four salivary gland tumours. Fourteen patients were operated upon whereas four received palliative treatment only. The median survival of the total group was 3.5 years. Particularly. in young patients because of the better cancer therapy and prolonged survival one must be aware of the increased risk of radiation-induced tumours.


Corresponding author

Address for correspondence: Dr A. J. M. Balm, Department of Otolaryngology – Head and Neck Surgery, The Netherlands Cancer Institute (Antoni van Leeuwenhoekhuis), Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.


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Amendola, B. E., Amendola, M. A., McClatchey, K. D. (1985) Radiation-induced carcinoma of the larynx. Surgery, Gynecotogy and Obstetrics 161: 3032.
Coia, L. R., Fazekas, J. T., Kramer, S. (1980) Postirradiation sarcoma of the head and neck: a report of three late sarcomas following therapeutic irradiation for primary malignancies of the paranasal sinus, nasal cavity, and larynx. Cancer 46: 19821985.
Coleman, C. N. (1982) Secondary neoplasms in patients treated for cancer; etiology and perspective. Radiation Research 92: 188200.
Donohue, W. L., Jaffe, F. A., Rewcastle, N. B. (1967) Radiation-induced neurofibromata. Cancer 20: 589595.
Eisenbud, L., Selub, L., Sciubba, J. (1982) Radiation-induced pseudosarcoma of the tongue. Oral Surgery 53: 6468.
Fleming, I. D., Black, T. L., Thompson, E. I., Pratt, C., Rao, B., Hustu, O. (1985) Thyroid dysfunction and neoplasia in children receiving neck irradiation for cancer. Cancer 55: 11901194.
Gane, N. F. C., Lindup, R., Strickland, P., Bennett, M. H. (1970) Radiation-induced fibrosarcoma. British Journat of Cancer 24: 705711.
Glaubiger, D. L., Casler, J. D., Garrett, W. L., Yuo, H. S., LillisHearne, P. K. (1991) Chondrosarcoma of the larynx after radiation treatment for vocal cord cancer. Cancer 68: 18281831.
Glaumer, R. (1949) Behandlung enzfindlicher erkrankungen mit rontgenstraheln. In Die Stralentherapie. (Meyer, H., Matthes, K., eds.). George Thieme Verlag, Stuttgart, pp 294322.
Griem, K. L., Robb, P. K., Caldarelli, D. D., Templeton, A. C. (1989) Radiation-induced sarcoma of the thyroid. Archives of Otolaryngology, Head and Neck Surgery 115: 991993.
Hall, P. F. L. (1991) Cancer risks after medical radiation. Medical Oncology and Tumor Pharmacotherapy 8: 141145.
Kumar, P. P., Newland, J. R. (1980) Radiation oncogenesis. Journal of the National Medical Association 72: 687690.
Liddington, M. I., Harrison, R. F, Path, M. R. C., Booth, A. P., Das Gupta, A. R. (1992) Radiation-induced antrochoanal fibrosarcoma. Journal of Laryngology and Otology 106: 547548.
Maisel, R. H., Carlos Manivel, J., Porto, D. P., Stanley, M. (1989) Postirradiation sarcomas of the head and neck. Ear, Nose and Throat Journal 68: 684701.
Maisel, R. H., Case, M. (1992) Squamous cell carcinoma after childhood radiation to the nasopharynx. Otolaryngology–Head and Neck Surgery 107: 783786.
Narula, A. A., Vallis, M. P., El-Silimy, O. F., Dowling, F.Bradley, P. J. (1986) Radiation-induced angiosarcomas of the nasopharynx. European Journal of Surgical Oncology 12: 147152.
Parker, R. G. (1990) Radiation-induced cancer as a factor in clinical decision making (the 1989 Astro Gold Medal Address). International Journal of Radiation Oncology and Biological Physics 18: 9931000.
Rennie, J. S., McLay, A., Tanner, N. S. B. (1983) Post-irradiation sarcoma of the lower lip. Journal of Laryngology and Otology 97: 871875.
Robinson, E., Neugut, A. I. (1990) The clinical behavior of radiation-induced thyroid cancer in patients with prior Hodgkin's disease. Radiotherapy and Oncology 17: 109113.
Schindel, J., Castoriano, I. M. (1972) Late-appearing (radiation-induced) carcinoma. Archives of Otolaryngology 95: 205210.
Spiegel, J., Bogdasarian, R. S. (1985) Retropharyngeal fibrosarcoma following radiation therapy for Hodgkin's lymphoma of the neck. Head and Neck Surgery 93: 274277.
SLeeves, R. A., Bataini, J. P. (1981) Neoplasms induced by megavoltage radiation in the head and neck region. Cancer 47: 17701774.
Stein, M., Lachter, J., Rennert, G., Bartal, A., Kuten, A. (1991) Thyroid cancer and multiple primary malignancies in Israel. Journal of Surgical Oncology 47: 221224.
Strauss, M. (1983) Long-term complications of radiotherapy confronting the head and neck surgeon. Laryngoscope 93: 310313.
Tucker, M. A. (1993) Secondary cancers. In Cancer: Principles and Practice of Oncology. 4th Edition. Vol. 2, (Devita, V. T. Jr., Hellman, S., Rosenberg, S. A., eds.), J. B. Lippincott Co., Philadelphia, pp 24072416.
United Nations Scientific Committee on the Effects of Atomic Radiation: Source. Effects and Risks of ionizing Radiation (1988), United Nations, New York.
Van Leeuwen, F. E., Somers, R., Taal, B. G., Van Heerde, P., Coster, B., Dozeman, T., Huisman, S. J., Hart, A. A. M. (1989) Increased risk of lung cancer, non-Hodgkin's lymphoma, and leukemia following Hodgkin's disease. Journal of Clinical Oncology 7: 10461058.
Van Leeuwen, F. E., Klokman, W. J., Hagenbeek, A., Noyon, R., Van de Belt-Dusebout, A. W., Van Kerkhoff, E. H. M., Van Heerde, P., Somers, R. (1994) Second cancer risk following Hodgkin's disease: a 20 year follow-up study. Journal of Clinical Oncology 12: 312325.
Van der Plaats, G. J. (1953) De biologische stralenwerking en bestralingsmethodes Medische Rontgentechniek. De Tijdstroom, Lochem, pp 185–265.
Watkin, G. T., Hobsley, M. (1986) Should radiotherapy be used routinely in the management of benign parotid tumours? British Journal of Surgery 73: 601603.
Weshler, Z., Wiesel, J. M., Gay, I., Sherman, J. (1983) Radiation-induced carcinoma of the middle ear. American Journal of Otology 5: 810.



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