Post-radiation sarcoma of the neck treated with re-irradiation followed by wide excision
Identifieur interne : 002428 ( Ncbi/Checkpoint ); précédent : 002427; suivant : 002429Post-radiation sarcoma of the neck treated with re-irradiation followed by wide excision
Auteurs : Alex Tan [Australie] ; Samuel Yk Ngan [Australie] ; Peter Fm Choong [Australie]Source :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2006.
Abstract
Post-radiation sarcoma (PRS) is an uncommon disease manifesting as sarcoma in a previously irradiated field, usually with a latent period of 5 years or more. Literature is limited to small series. Optimal management of this disease is unclear. Positive margins are common following attempted curative surgery and outcomes are poor. Radiotherapy is hardly used and its effect on PRS is not known. We described a case of PRS treated with preoperative radiotherapy followed by margin-negative wide excision.
The 59-year-old patient presented with a mass in the left supraclavicular fossa and numbness in the arm, six years following radical irradiation of the head and neck for nasopharyngeal carcinoma. Open biopsy showed pleomorphic spindle cell sarcoma. She was treated with pre-operative hyperfractionated radiotherapy followed by margin-negative wide excision and nerve grafting. Cumulative radiation dose to the supraclavicular fossa was 98 Gy. Histological examination of the post-irradiation tumor specimens showed evidence of significant tumor response to re-irradiation. The patient remained free of disease five years after surgery with excellent functional outcome.
Role of radiotherapy in PRS is uncertain. We described a case that was successfully managed with preoperative radiotherapy and margin-negative wide excision in terms of tumor control and functional outcomes. The impact of radiotherapy was demonstrated in the post-irradiation resected specimen. Further investigation using re-irradiation and surgery in PRS is warranted.
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DOI: 10.1186/1477-7819-4-69
PubMed: 17018155
PubMed Central: 1592488
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Yk" uniqKey="Ngan S" first="Samuel Yk" last="Ngan">Samuel Yk Ngan</name><affiliation wicri:level="1"><nlm:aff id="I1">Sarcoma Unit, Peter MacCallum Cancer Centre, Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sarcoma Unit, Peter MacCallum Cancer Centre, Melbourne</wicri:regionArea><wicri:noRegion>Melbourne</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">The University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The University of Melbourne, Parkville</wicri:regionArea><wicri:noRegion>Parkville</wicri:noRegion></affiliation></author><author><name sortKey="Choong, Peter Fm" sort="Choong, Peter Fm" uniqKey="Choong P" first="Peter Fm" last="Choong">Peter Fm Choong</name><affiliation wicri:level="1"><nlm:aff id="I1">Sarcoma Unit, Peter MacCallum Cancer Centre, Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sarcoma Unit, Peter MacCallum Cancer Centre, Melbourne</wicri:regionArea><wicri:noRegion>Melbourne</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">The University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The University of Melbourne, Parkville</wicri:regionArea><wicri:noRegion>Parkville</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Department of Orthopedic Surgery, St Vincent's Hospital, Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Orthopedic Surgery, St Vincent's Hospital, Melbourne</wicri:regionArea><wicri:noRegion>Melbourne</wicri:noRegion></affiliation></author></analytic><series><title level="j">World Journal of Surgical Oncology</title><idno type="eISSN">1477-7819</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Post-radiation sarcoma (PRS) is an uncommon disease manifesting as sarcoma in a previously irradiated field, usually with a latent period of 5 years or more. Literature is limited to small series. Optimal management of this disease is unclear. Positive margins are common following attempted curative surgery and outcomes are poor. Radiotherapy is hardly used and its effect on PRS is not known. We described a case of PRS treated with preoperative radiotherapy followed by margin-negative wide excision.</p></sec><sec><title>Case presentation</title><p>The 59-year-old patient presented with a mass in the left supraclavicular fossa and numbness in the arm, six years following radical irradiation of the head and neck for nasopharyngeal carcinoma. Open biopsy showed pleomorphic spindle cell sarcoma. She was treated with pre-operative hyperfractionated radiotherapy followed by margin-negative wide excision and nerve grafting. Cumulative radiation dose to the supraclavicular fossa was 98 Gy. Histological examination of the post-irradiation tumor specimens showed evidence of significant tumor response to re-irradiation. The patient remained free of disease five years after surgery with excellent functional outcome.</p></sec><sec><title>Conclusion</title><p>Role of radiotherapy in PRS is uncertain. We described a case that was successfully managed with preoperative radiotherapy and margin-negative wide excision in terms of tumor control and functional outcomes. The impact of radiotherapy was demonstrated in the post-irradiation resected specimen. Further investigation using re-irradiation and surgery in PRS is warranted.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Tan, Alex" sort="Tan, Alex" uniqKey="Tan A" first="Alex" last="Tan">Alex Tan</name></noRegion><name sortKey="Choong, Peter Fm" sort="Choong, Peter Fm" uniqKey="Choong P" first="Peter Fm" last="Choong">Peter Fm Choong</name><name sortKey="Choong, Peter Fm" sort="Choong, Peter Fm" uniqKey="Choong P" first="Peter Fm" last="Choong">Peter Fm Choong</name><name sortKey="Choong, Peter Fm" sort="Choong, Peter Fm" uniqKey="Choong P" first="Peter Fm" last="Choong">Peter Fm Choong</name><name sortKey="Ngan, Samuel Yk" sort="Ngan, Samuel Yk" uniqKey="Ngan S" first="Samuel Yk" last="Ngan">Samuel Yk Ngan</name><name sortKey="Ngan, Samuel Yk" sort="Ngan, Samuel Yk" uniqKey="Ngan S" first="Samuel Yk" last="Ngan">Samuel Yk Ngan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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