Radiation-induced sarcomas of the head and neck in post-radiation nasopharyngeal carcinoma

Radiotherapy (RT) is the curative treatment modality for nasopharyngeal carcinoma (NPC), which is a common tumor in the southern Chinese population. However, ionizing radiation is itself a known carcinogen. There is a large population at risk of developing sarcomas in the irradiated fields. Compared with post-radiation squamous cell carcinoma (SCC) [ 1 ], radiation-induced sarcomas (RIS) of the head and neck following RT for NPC are even less common, with a crude incidence in adults of less than 0.5 % in various situations [ 1 – 5 ]. With improved patient survival [ 6 – 8 ], RIS is likely to be encountered more frequently. It is now generally believed that complete surgical resection of RIS provides the only chance of a cure [ 3 , 4 ]. Unfortunately, the reported prognosis is poor owing to advanced RIS at diagnosis [ 3 , 4 , 9 ]. RIS has become a critical problem that can limit long-term survival and hinder quality of life. To detect an RIS at an earlier stage, the radiologist should be aware of the common radiological appearances, which can be scrutinized on follow-up scans.