Abstract
Introduction
The development of a secondary malignancy in the field of radiation is a rare, but well-recognized hazard of cancer treatment. Radiotherapy-induced (RT-I) tumors have become increasingly important because of the longer life of the general population, even the oncologic patients. The goal of this study is to report a case of RT-I neural tumor located in the spine and to perform a systematic review of the secondary tumor induced by radiotherapy to the spine.
Materials and Methods
A case of neural tumor secondary to radiotherapy to the spine was reported and a literature search of the cases of RT-I spine tumors was performed using an online database, Pubmed.gov. After exclusion criteria, 22 articles with 28 cases were included in the study. The variables analyzed were patient's age, gender, primary and secondary tumor histology, tumor location, time of development of the secondary tumor, treatment options, and outcome.
Results
The mean age of the patients at diagnosis of the induced tumor was 39.20 ( ± 17.02) years. Most of them were males (62.1%). The main type of primary disease was neural tumors (27.6%). The RT-I tumors were diagnosed within a mean of 17.1 ( ± 9.6) years after the radiotherapy (min 3–max 40). The most common type of histology was fibrosarcoma (20.7%). No difference was found in age, gender, and time for diagnosis between neural and nonneural tumors. The mean survival after the diagnosis of the secondary tumor was 10.66 months ( ± 12.96) and neural tumors had a longer survival period (p = 0.031).
Conclusion
Most of the RT-I tumors are secondary to the treatment of Hodgkin Lymphoma with radiotherapy, sarcoma being the most frequent. The current gold standard is complete resection with clear margins. The neural tumor type had a longer survival period.