PDF(Pubmed)
Abstract：
Background Radiation therapy is a mainstay of treatment for brain tumors, but delayed complications include secondary malignancy which may occur months to years after treatment completion. Methods We reviewed the medical records of a 41-year-old female treated with 60 Gy of radiation for a recurrent astrocytoma, who 6 years later developed a locally advanced sinonasal teratocarcinosarcoma. We searched MEDLINE, Embase, and Web of Science to conduct a scoping review of biopsy-proven sinonasal malignancy in patients who previously received cranial irradiation for a brain tumor. Results To our knowledge, this is the first report of a patient to present with a sinonasal teratocarcinosarcoma after receiving irradiation for a brain tumor. Our scoping review of 1,907 studies produced 14 similar cases of secondary sinonasal malignancy. Median age of primary cancer diagnosis was 39.5 years old (standard deviation [SD]: 21.9), and median radiation dose was 54 Gy (SD: 20.3). Median latency time between the primary cancer and secondary sinonasal cancer was 9.5 years (SD: 5.8). Olfactory neuroblastoma was the most common sinonasal cancer ( n = 4). Fifty percent of patients died from their sinonasal cancer within 1.5 years. Conclusion Patients who receive radiation exposure to the sinonasal region for treatment of a primary brain tumor, including low doses or scatter radiation, may be at risk of a secondary sinonasal malignancy later in life. Physicians who monitor at-risk patients must be vigilant of symptoms which may suggest sinonasal malignancy, and surveillance should include radiographic review with careful monitoring for a secondary malignancy throughout the entire irradiated field.
摘要：
背景技术放射治疗是脑肿瘤治疗的主要手段,但延迟性并发症包括继发性恶性肿瘤，可在治疗完成后数月至数年发生。方法我们回顾了一名41岁女性因复发性星形细胞瘤接受60Gy辐射治疗的医疗记录，6年后发展为局部晚期鼻窦畸胎癌肉瘤。我们搜索了MEDLINE,Embase,和WebofScience对之前接受过头颅照射的患者进行活检证实的鼻窦恶性肿瘤的范围审查。结果据我们所知，这是首次报告一名患者在接受脑肿瘤照射后出现鼻窦畸胎性肉瘤。我们对1,907项研究的范围审查产生了14例类似的继发性鼻窦恶性肿瘤病例。原发癌诊断的中位年龄为39.5岁(标准差[SD]:21.9),中位辐射剂量为54Gy(SD:20.3)。原发性癌和继发性鼻窦癌的中位潜伏期为9.5年(SD:5.8)。嗅觉神经母细胞瘤是最常见的鼻窦肿瘤（n=4）。50%的患者在1.5年内死于鼻窦癌。结论接受鼻窦区域辐射治疗原发性脑肿瘤的患者，包括低剂量或散射辐射，在以后的生活中可能有继发性鼻窦恶性肿瘤的风险。监测高危患者的医生必须警惕可能提示鼻窦恶性肿瘤的症状，监测应包括影像学检查，并仔细监测整个辐照场的继发性恶性肿瘤。
