%0 Review
%T Radiation-Induced Oropharyngeal Squamous Cell Carcinoma: Case Report and Review of the Literature.
%A Giannini L
%A Alliata A
%A Cristofaro V
%A Incandela F
%A Pompilio M
%A Ottini A
%A Cavalieri S
%A Nuzzolese I
%A Iacovelli NA
%A Franceschini M
%A Deganello A
%J Curr Oncol
%V 30
%N 7
%D 2023 07 14
%M 37504352
%F 3.109
%R 10.3390/curroncol30070492
%X 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%.
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.
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.
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.