Neuroendocrinology
Research Article
Post-Radiation Grade 3 Neuroendocrine Carcinoma: A New Entity?Hadoux J.a · Blanchard P.b · Scoazec J.-Y.c · Burtin P.d · Planchard D.d · Malka D.d · Berdelou A.a · Boige V.d · Duvillard P.c · Leboulleux S.a · Faron M.e · Tselikas L.f · Deutsch E.b · Ducreux M.d · Baudin E.aaDépartement d’Imagerie, Service d’Oncologie Endocrinienne, Université Paris-Saclay, Villejuif, France
bDépartement de Radiothérapie, Université Paris-Saclay, Villejuif, France cDépartement de Biologie et Pathologie Médicale, Université Paris-Saclay, Villejuif, France dDépartement de Médecine Oncologique, Université Paris-Saclay, Villejuif, France eDépartement de Chirurgie Oncologique, Université Paris-Saclay, Villejuif, France fDépartement d’Imagerie, Service de Radiologie Interventionnelle, Université Paris-Saclay, Villejuif, France |
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Article / Publication Details
Received: May 21, 2019
Accepted: October 21, 2019
Published online: October 22, 2019
Issue release date: December 2020
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2
ISSN: 0028-3835 (Print)
eISSN: 1423-0194 (Online)
For additional information: https://www.karger.com/NEN
Abstract
Background: Cancer survivors have a 14% increased risk of developing a malignancy compared with the general population. Second radiation-induced malignancies with different histologies have been described in different organs. Based on individual observations, we hypothesized that neuroendocrine carcinoma (NEC) could arise in irradiated organs. Methods: In a retrospective analysis of Gustave Roussy database of NEC patients (small cell lung cancer excluded) diagnosed as a second cancer, we looked for the frequency of grade 3 NEC that arose in patients who had received previous radiation therapy for a first cancer. Radiation therapy for the first cancer, dose, location of radiation therapy, pathological characteristics, overall survival, and response to treatment of secondary NEC were analyzed. Results: From January 1995 to December 2017, 847 cases of NEC were seen at Gustave Roussy. Among them, 95 (11.2%) patients had a history of previous malignancy of which 36 (4%) had been treated with radiation therapy. Out of these 36 patients, 12 (1.4% of all NEC patients) developed a NEC within the previous irradiated organ (median dose of 50 Gy, range 36–67.5). Most frequent first cancers were breast cancer (n = 4) and Hodgkin lymphoma (n = 3). NEC arose within a median time of 21.7 years (range 5.1–36.4) from radiation in the thorax (n = 5), digestive tract (n = 3), and other sites. Five large cell NEC, 3 small cell NEC, 1 mixed neuroendocrine neoplasm and 3 not otherwise specified NEC were diagnosed. Ten patients had stage IV disease at diagnosis; median overall survival was 37.8 months (95% CI [17.6 to NA]). Three patients (25%) achieved complete response with multimodal treatment. Conclusions: NEC can arise from previously irradiated organs and may have a better outcome in this setting. Other risk factors should be investigated to explain the high rate of previous cancer in this population of neuroendocrine neoplasm.
© 2019 S. Karger AG, Basel
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Article / Publication Details
Received: May 21, 2019
Accepted: October 21, 2019
Published online: October 22, 2019
Issue release date: December 2020
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2
ISSN: 0028-3835 (Print)
eISSN: 1423-0194 (Online)
For additional information: https://www.karger.com/NEN
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