Cutaneous carcinoma induced by radiotherapy: A report of 31 cases
##plugins.themes.academic_pro.article.main##
Abstract
Background: Depilatory radiotherapy was used in the sixties as a treatment for ringworm in Tunisia. Subsequently some of these patients developed radio-induced carcinomas of the scalp.
aim: To present the epidemiological, clinical, pathological,therapeutic features and out come of radio-induced cutaneous carcinomas.
methods: We conducted a retrospective study performed in the dermatology department of the La Rabta hospital of Tunis over a 6- year-period recording all histologically confirmed carcinomas in patients irradiated in childhood for tinea capitis.
results: Thirty one patients were included with 49 tumors: 47 basal cell carcinomas and 2 squamous cell carcinomas. The average latent period between the irradiation and the appearance of the carcinomas was of 35.7 years. The average age was 53 years. A male predominance was noted, with a sex ratioM/F of 6.75. Clinically, basal cell carcinomas were nodular in all cases. Surgery was indicated in 90% of cases. Cryosurgery and radiotherapy were used respectively in 1 and 2 patients.
Conclusion: Our study shows that radio-induced cutaneous carcinomas are widely dominated by basal cell carcinoma. They arise, approximately, ten years earlier than carcinoma in patients with no history of scalp irradiation. However X-ray exposure does not seem to influence clinical or histological presentation, therapeutic modalities nor prognosis of these tumors. The prognosis of radioinduced cutaneous carcinomas was globally similar to that of other cutaneous carcinomas with same histological type and equivalent degree of invasion.
aim: To present the epidemiological, clinical, pathological,therapeutic features and out come of radio-induced cutaneous carcinomas.
methods: We conducted a retrospective study performed in the dermatology department of the La Rabta hospital of Tunis over a 6- year-period recording all histologically confirmed carcinomas in patients irradiated in childhood for tinea capitis.
results: Thirty one patients were included with 49 tumors: 47 basal cell carcinomas and 2 squamous cell carcinomas. The average latent period between the irradiation and the appearance of the carcinomas was of 35.7 years. The average age was 53 years. A male predominance was noted, with a sex ratioM/F of 6.75. Clinically, basal cell carcinomas were nodular in all cases. Surgery was indicated in 90% of cases. Cryosurgery and radiotherapy were used respectively in 1 and 2 patients.
Conclusion: Our study shows that radio-induced cutaneous carcinomas are widely dominated by basal cell carcinoma. They arise, approximately, ten years earlier than carcinoma in patients with no history of scalp irradiation. However X-ray exposure does not seem to influence clinical or histological presentation, therapeutic modalities nor prognosis of these tumors. The prognosis of radioinduced cutaneous carcinomas was globally similar to that of other cutaneous carcinomas with same histological type and equivalent degree of invasion.
Keywords:
Basal cell carcinoma, Squamous cell carcinoma, Radiotherapy, Tinea capitis##plugins.themes.academic_pro.article.details##
References
- Z eg laoui F, Faza a B, Mok htar I, et al. Les cancers cutanés après ra dio thérapi e po ur teig ne da ns l ' en f an ce. M ag hre b Méd 19 97; 320 : 43-5.
- Maal e j M, F r ik ha H , K oc hb a ti L, et al . Radio- in duced mal ign an cie s of t he scalp abou t 98 pa tien ts wit h 1 50 lesi ons and li tera ture revie w. Cancer Ra dio ther 2 004; 8 : 8 1-7.
- Co ulomb A. A ge nc e nat ional e d'acc réditat ion et dévalu a tio n en san té (ANAES) 2 004 . R e co mm a ndat ion s p our la prat iqu e cli niq ue . Ann De r mato l Venereol 20 04; 131 : 669-75 6.
- Fr e ib en A . D emo nstrat io n ei nes c a bcro id s d e s rech ten han dri ick e ns das nach lan gdau e r nd er e in w ir ki ng v on rotgenstrah len en twick-el t h a tt e . Fort schr G e t Roen tg en ol 190 2; 7: 106 .
- Hennqu in C , Du r dux C, Hou sset M , Ma ay li n C. Ap pr oc he t hérap e ut iq ue d e s can c e r s ( I I I ) EM C R a di ot hérapie t hér ap eu ti que 1 997; 12 : 1- 3.
- F ietk a u R , Die pgen T L, St e hr L, S au e r R. Ind uc ti on of m a lig na nc ies by ra diothera py: a ret ro spective s tud y o f 45 4 t umo r s. Str ah lent he r Onk ol 1988 ; 164: 24 7-59.
- Clav ère P, B onnet blanc J M. Ca rci nom es c utanés radio-i ndui ts . An n Dermat ol Ve ne reo l 1 995; 1 22: 395 - 7.
- Alb ert RE, O mran A R, Bra ue r E , e t al. Fo llo w up study of p atient s tre ate d b y X-Ra y for tinea ca pitis . Am J Pu blic Hea lt h 1 996; 56 : 2114-20 .
- Bo ice J D . C a nc e r f ol lowing irradi a ti on in ch il dho od an d ado lesce nce . M ed Pe diatr Oncol 199 6; 1: 29 -3 4.
- C oss et JM. Ca nc ers radio-in dui ts: le p oin t e n 1997. Cance r R ad iother 1997 ; 1 : 823-35 .
- Shore RE , Mose son M , Xue X, Tse Y, H arle y N, P asternack B S. S kin c an cer aft er X -ray tre a tment for sc alp ri ngworm. Ra diat R es 20 02; 15 7: 410-8 .
- R on E, Mod an B, Preston D , Alfa ndary E, Stoval l M , Bo ice JD. R ad iation i nduced s kin carc ino mas of the hea d a nd neck. Ra diat R es 19 91; 12 5: 318-2 5.
- M sedd i M, B ouas sida S, M a r r e kchi S et al . Bas a l cell ca r cinom a of the sca lp a f ter radi a tio n thera py f or t inea capiti s: 33 patie nts. Cance r ra dio ther 2 004; 8 : 2 70-3.
- Handa Y, Miwa S , Yama da M, Ono H, Suzuki T, To mi ta Y.M ultip le pigm en ted b asa l cell carc inoma aris ing in th e norm alapp eari ng sk in after ra dio therapy for car cinoma of the ce r vix . Dermat ol S ur g 20 03; 29 : 1 233-5 .
- Arai T, Nakano T, Fuku his a K, e t al. Second ca nc e r a f ter radi atio n t he r ap y for cance r of t he ut erine ce r vix . C an cer 1 991; 6 7: 398-4 05.
- Alber t RE, Om ran AR , Nra U er EW. Fo ll ow- up study of p atients treated by X-ray f or tin e a ca pitis . Am J Pub li c Hea lt h 1 966; 56 : 2114-20 .
- Zahaf A, Mk ao ua r M, Char f i C H , R eb éi S . Epi thel ioma s du cuir chevel u second air es à une ra dio théra pie po ur tei gne à pr opos de 1 2 cas. Nouv Der mato l 1988 ; 7 : 35 9- 61.