Postoperative Clinical Radiosensitivity in Patients With Fanconi Anemia and Head and Neck Squamous Cell Carcinoma
- 1 September 2011
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA Otolaryngology–Head & Neck Surgery
- Vol. 137 (9), 930-4
- https://doi.org/10.1001/archoto.2011.154
Abstract
To describe the complications and adverse effects of postoperative radiotherapy in patients with Fanconi anemia (FA). Cohort study. Patients with FA treated at community and tertiary care hospitals throughout the United States. The study included patients with FA who were enrolled in the International FA Registry (IFAR) and who developed head and neck squamous cell carcinoma and received postoperative radiotherapy. Demographics of patients with FA and adverse effects and dosages of radiotherapy. Twelve patients with FA (7 men and 5 women) were identified. They developed cancers at a mean age of 35.5 years (age range, 20-48 years). The sites of primary cancer were the oral cavity (n = 8), larynx (n = 2), pharynx (n = 1), and unknown (n = 1). The median radiation dose was 5590 cGy (range, 2500-7020 cGy). The most common adverse effects were mucositis (n = 9), dysphagia (n = 8), and pancytopenia (n = 6). Other complications included esophageal stenosis, laryngeal edema, and wound breakdown. Radiotherapy could not be completed in 5 cases. Overall, 8 patients died, 4 during the course of radiotherapy. The postoperative disease-free survival time ranged from 0 to 55 months. Patients with FA have a high rate of complications from radiotherapy. Common adverse effects, particularly mucositis, are especially prevalent and difficult to manage in this population. Pancytopenia is common and may lead to further complications, particularly bleeding and infection. Overall survival is poor. Further study of the response to radiotherapy in patients with FA should be attempted to establish appropriate dosages to balance treating disease while limiting adverse effects.Keywords
This publication has 19 references indexed in Scilit:
- Mutations of the SLX4 gene in Fanconi anemiaNature Genetics, 2011
- The Fanconi Anemia Pathway Promotes Replication-Dependent DNA Interstrand Cross-Link RepairScience, 2009
- Squamous cell carcinoma of base of tongue in a patient with Fanconi's anemia treated with radiation therapy: Case report and review of literatureHead & Neck, 2009
- Cancer risks in Fanconi anemia: findings from the German Fanconi Anemia RegistryHaematologica, 2008
- Adjuvant radiotherapy improves overall survival for patients with lymph node‐positive head and neck squamous cell carcinomaCancer, 2007
- Alcohol Drinking in Never Users of Tobacco, Cigarette Smoking in Never Drinkers, and the Risk of Head and Neck Cancer: Pooled Analysis in the International Head and Neck Cancer Epidemiology ConsortiumJNCI Journal of the National Cancer Institute, 2007
- Acute graft-versus-host disease in patients with Fanconi anemia or acquired aplastic anemia undergoing bone marrow transplantation from HLA-identical sibling donors: risk factors and influence on outcomeBlood, 2004
- A 20-year perspective on the International Fanconi Anemia Registry (IFAR)Blood, 2003
- Cancer in Fanconi anemia, 1927–2001Cancer, 2003
- Evaluation of the dose for postoperative radiation therapy of head and neck cancer: First report of a prospective randomized trialInternational Journal of Radiation Oncology*Biology*Physics, 1993