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Second malignant tumors in patients with nasopharyngeal carcinoma and their association with Epstein‐Barr virus
Author(s) -
Wang ChunChieh,
Chen MongLiang,
Hsu KuangHung,
Lee Steve P.,
Chen TseChing,
Chang YuSun,
Tsang NganMing,
Hong JiHong
Publication year - 2000
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/1097-0215(20000715)87:2<228::aid-ijc12>3.0.co;2-t
Subject(s) - nasopharyngeal carcinoma , medicine , cancer , incidence (geometry) , gastroenterology , confidence interval , retrospective cohort study , head and neck cancer , carcinoma , cohort , oncology , radiation therapy , physics , optics
Since previous published studies about second malignant tumors (SMTs) in nasopharyngeal carcinoma (NPC) patients usually included a limited sample size and did not attain consistent results, we conducted a large retrospective study in a cohort of 1,549 patients to assess the risk of SMT in NPC patients following radiotherapy (RT) in Taiwan. The follow‐up period ranged from 2 to 16 years, with a median of 7 years. Thirty‐nine patients developed SMTs during the 7,145 person‐year follow‐up [standardized incidence ratio (SIR): 2.8; 95% confidence interval (CI): 2.0 to 3.9]. Increased risks of developing SMTs were observed for head and neck (H/N) cancer (SIR: 16.5; 95% CI: 10.0 to 26.8), gastric cancer (SIR: 5.5; 95% CI: 2.2 to 11.4) and leukemia (SIR: 9; 95% CI: 1.9 to 26.3). Paraffin‐embedded specimens of secondary H/N cancer (11), secondary gastric cancer (6) and their corresponding NPC specimens were examined by EBER in situ hybridization to assess the association between Epstein‐Barr virus (EBV) and these SMTs. Twenty‐six primary H/N and 5 gastric cancer specimens were chosen as the control groups. In H/N cancer, EBV was detected in 3.8% of the primary cancers and 9.1% of the secondary cancers. All the positive specimens resulted from hypopharyngeal cancer. Of the secondary gastric cancers, only 1 case (16.6%) was associated with EBV. None of the primary gastric cancers was associated with EBV. Our results indicate an increased risk of developing SMTs, with a preference for head and neck cancer, gastric cancer and leukemia, in NPC patients after RT in Taiwan. Only a small proportion of the secondary H/N and gastric cancers was associated with EBV. Int. J. Cancer 87:228–231, 2000. © 2000 Wiley‐Liss, Inc.