S631
Clinical – Head & neck
ESTRO 2026
Purpose/Objective: The 5-year overall survival (OS) rate of Nasopharyngeal Carcinoma (NPC) patients has reached 80%, and the prevalence of Second Primary Malignancies (SPMs) in long-term survivors is much higher than that in the general population. This study aims to identify the predictor factors of SPM occurrence to guide potential lifestyle and therapeutic interventions. Material/Methods: This population-based cohort study utilized data from the Clinical Data Analysis and Reporting System (CDARS), including 7,893 NPC patients who achieved five-year survival following diagnosis in Hong Kong between 1997 and 2015. SPMs were identified using ICD-9 codes (codes 140–195, 200–208), excluding secondary malignancies (196–198) and SPMs diagnosed within six months of initial NPC. The cumulative incidence of SPMs was estimated via the Kaplan-Meier method, and standardized incidence ratios (SIRs) were calculated to compare site-specific cancer risks to those in the general population. To explore potential risk factors, we extracted data on demographic variables, treatment modalities, comorbidities, and concomitant medications, analyzing associations through multivariable Cox proportional hazards models. Results: After median follow-up time of 11.3 years (range: 0.5- 24.0), in this cohort of 7,893 NPC survivors, a total of 1,036 SPMs were observed, with a cumulative incidence of 13.13%. The 10-, 15-, and 20-year incidence rates were 9.0%, 15.3%, and 22.9%, respectively. Compared with the general population, the risk of SPMs was most pronounced for Nasal cavity tumors (SIR = 38.44, 95% CI: 28.97-51.00), followed by Tongue tumors (SIR = 26.86, 95% CI: 22.36-32.27) and Soft tissue and bone sarcoma (SIR = 19.93, 95% CI: 16.13-24.62) (Table 1). The heightened risk pattern underscores the potential influence of radiotherapy and field cancerization effects. Multivariable analysis also indicated a significant association between Re- irradiation and SPMs risk (HR = 1.32, 95% CI: 1.01–1.72, p < 0.05). Additionally, alcohol consumption (HR = 1.32, 95% CI: 1.13–1.53, p < 0.001) and the use of diuretics (HR = 1.33, 95% CI: 1.16–1.53, p < 0.001), NSAIDs (HR = 1.27, 95% CI: 1.09–1.47, p = 0.002), anticoagulants (HR = 1.37, 95% CI: 1.12–1.67, p = 0.002) and antifibrinolytics (HR = 1.56, 95% CI: 1.37–1.77, p < 0.001) were positively associated with SPMs development, whereas antiplatelet (HR = 0.82, 95% CI: 0.71–0.96, p < 0.05) use were inversely associated (Figure 1).
according to CTCAE criteria (version 5), late side effects according to LENT_SOMA. The psychosocial burden after therapy-related (partial) nose resection was recorded using the Rhinoplasty outcomes evaluation German (ROE-D) questionnaire. Results: After surgical therapy with adjuvant radiotherapy, a satisfactory local (96.6%) and locoregional control (90.1%) was achieved after five years. As a consequence of radiation, all patients showed pronounced toxicities, especially of the skin, conjunctiva and oral and nasal mucosae (median, grade 2). Late side effects were milder and were present in 75% of patients (median, grade 1). Concerning their external appearance, 25% of the patients reported a high level of dissatisfaction. 29% always or often felt impaired in professional or social activities. 42% were seeking a surgical revision of the nose. Conclusion: Surgical therapy followed by adjuvant radiotherapy results in satisfactory local and locoregional control. Psychosocial limitations are evident after the completion of treatment. Therefore, therapeutic options involving organ preservation are of particular importance for carcinomas of the nasal vestibule. These therapeutic concepts should be explored further. Keywords: nasal vestibule carcinoma, psychosocial distress Incidence of Second Primary Malignancies in Nasopharyngeal Carcinoma Survivors After Radiotherapy: A Population-Based Retrospective Study Ruyu Xu 1 , Philip CM Au 2 , Kenneth SK Chan 1 , CW Sing 1 , John KS Fong 1 , James CH Chow 3 , Ken KM Cheung 3 , Winnie WY Tin 4 , Edwin CY Wong 5 , Tracy TS Lau 6 , Kenneth CW Wong 7 , Ann SY Chan 8 , Victor HF Lee 1 , Anne WM Lee 1 , Wai Tong Ng 1 , Ian CK Wong 2 , Ching Lung Cheung 2 , Chi Leung Chiang 1 1 Department of Clinical Oncology, University of Hong Kong, Hong Kong, China. 2 Department of Pharmacy and Pharmacology, University of Hong Kong, Hong Kong, China. 3 Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China. 4 Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China. 5 Department of Clinical Oncology, Pamela Youde Nethersole Hospital, Hong Kong, China. 6 Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, China. 7 Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong, China. 8 Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China Mini-Oral 3708
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