59. Second Cancer Following Radiation Therapy for Uterine Cervical Carcinoma.
Tatsuya Ohno, Hirohiko Tsujii,
Kenjiro Fukuhisa, Shinroku Morita,
Reiko Imai, Takashi Nakano1 and Tatsuo Arai2
(1 Gunma Univ. School of Medicine;
2 Motojima General Hospital)
Keywords: second cancer, radiation therapy, cervical carcinoma
Purpose: To examine the incidence and clinical feature of second cancer following radiation therapy.
Materials and methods: Between 1961 and 1990, 1877 patients with uterine cervical squamous cell carcinoma were treated radically with radiation therapy alone at NIRS. Patients were followed up intensively; 10 years after radiation therapy the follow up rate was more than 90%. We diagnosed a radiation-associated second cancer using the following criteria: (1) difference of histologic type from the primary cancer (except for vagina); (2) latency period of at least 2 years after radiation therapy (RT); and (3) development site in the irradiated field.
Results: Twenty-nine of 1877 (1.54%) patients developed second cancer. The sites of second cancer were rectum in 8 patients, bladder in 3, uterus in 6, ovary in 5, vagina in 2, and bone and soft tissue in 5. Patient age at diagnosis of cervical carcinoma was 40 to 75 years, with a median of 58 years and at diagnosis of second cancer was 49 to 95 years, with a median of 72 years. Latency period from RT to the development of second cancer ranged from 3 to 27 years, with a median of 16 years. Treatment of second cancer consisted of surgery in 12 patients (41%), RT in 4 (14%), and chemotherapy in 1 (3%). Median survival from the diagnosis of second cancer was 7 months.
Conclusion: Radiation therapy for cervical carcinoma results in large numbers of long term survivors who can develop second cancers very late in life. The advantage of radiation therapy may be considered large enough to compensate for the risk of radiation-associated cancer.