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Peer-reviewedCC BY 4.0Cancers

Impact of Second Primary Cancers on Treatment Modifications in Patients with Newly Diagnosed Head and Neck Cancer Referred for Curative-Intent Radiotherapy: A Retrospective Study

  • Mirte Bortels1,2,3
  • Heleen Bollen1,2
  • Bjorn Baerts4
  • Olivier Beckers5
  • Caroline Bongers6
  • Kristof Deben6
  • Mieke Govers1,2
  • Jan Jacobs4
  • Johan Orye4
  • Anne-Sophie Van de Velde1,2
  • Jasmien Cornillie7,8
  • Eric Joosens7,8
5 more authors
  • Ferdinand Mennens7,8
  • Kristof Menten9
  • Annelies Requilé7,8
  • Daisy Jeurissen1,2
  • Annelies Maes1,2
9 affiliations
  1. 1Department of Radiation Oncology, Limburg Oncological Center (Jessa Hospital and Hospital Oost-Limburg), 3500 Hasselt, Belgium
  2. 2Department of Radiation Oncology, Limburg Oncological Center (Jessa Hospital and Hospital Oost-Limburg), 3600 Genk, Belgium
  3. 3Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
  4. 4Department of Oral and Maxillofacial Surgery, Jessa Hospital, 3500 Hasselt, Belgium
  5. 5Department of Oral and Maxillofacial Surgery, Hospital Oost-Limburg, 3600 Genk, Belgium
  6. 6Department of Otorhinolaryngology, Jessa Hospital, 3500 Hasselt, Belgium
  7. 7Department of Medical Oncology, Limburg Oncological Center (Jessa Hospital and Hospital Oost-Limburg), 3500 Hasselt, Belgium
  8. 8Department of Medical Oncology, Limburg Oncological Center (Jessa Hospital and Hospital Oost-Limburg), 3600 Genk, Belgium
  9. 9Department of Otorhinolaryngology, Hospital Oost-Limburg, 3600 Genk, Belgium
Open at sourceDOICite

Abstract

Objective: Development of second primary cancers (SPCs) is a significant risk for head and neck cancer (HNC) patients. This study investigates the impact of synchronous and metachronous SPCs on treatment strategies of newly diagnosed HNC. Methods: We retrospectively analyzed patients referred for curative-intent radiotherapy between 2022 and 2024. The primary outcome was the impact of SPCs on HNC (chemo)radiotherapy strategies, with SPC prevalence and distribution as secondary outcomes. Results: A total of 285 patients were included. In 28.4% an SPC was observed. A total of 8.4% had a synchronous malignancy, 16.5% were treated for another malignancy in the past and 3.5% presented with both a synchronous and metachronous cancer. The treatment was impacted in 37.0% of patients with an SPC. Treatment modifications included altered radiotherapy field (23.5%), treatment delays (13.6%), adjusted radio- or chemotherapy regimens (2.5% each), and transition to palliative care (1.2%). Conclusion: A substantial proportion of SPCs influenced the radiotherapy (RT) management in all domains. The complexity of treatment was further increased by the need for additional pre-treatment evaluations and consideration of prior therapies.

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Cite

BibTeXRIS
BibTeX
@article{bortels2026impact,
  title = {{Impact of Second Primary Cancers on Treatment Modifications in Patients with Newly Diagnosed Head and Neck Cancer Referred for Curative-Intent Radiotherapy: A Retrospective Study}},
  author = {Mirte Bortels and Heleen Bollen and Bjorn Baerts and Olivier Beckers and Caroline Bongers and Kristof Deben and Mieke Govers and Jan Jacobs and Johan Orye and Anne-Sophie Van de Velde and Jasmien Cornillie and Eric Joosens and Ferdinand Mennens and Kristof Menten and Annelies Requilé and Daisy Jeurissen and Annelies Maes},
  journal = {Cancers},
  year = {2026},
  month = nov,
  doi = {10.3390/cancers18223604},
  url = {https://www.mdpi.com/2072-6694/18/22/3604},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Impact of Second Primary Cancers on Treatment Modifications in Patients with Newly Diagnosed Head and Neck Cancer Referred for Curative-Intent Radiotherapy: A Retrospective Study
AU  - Mirte Bortels
AU  - Heleen Bollen
AU  - Bjorn Baerts
AU  - Olivier Beckers
AU  - Caroline Bongers
AU  - Kristof Deben
AU  - Mieke Govers
AU  - Jan Jacobs
AU  - Johan Orye
AU  - Anne-Sophie Van de Velde
AU  - Jasmien Cornillie
AU  - Eric Joosens
AU  - Ferdinand Mennens
AU  - Kristof Menten
AU  - Annelies Requilé
AU  - Daisy Jeurissen
AU  - Annelies Maes
PY  - 2026
DA  - 2026/11/11
JO  - Cancers
DO  - 10.3390/cancers18223604
UR  - https://www.mdpi.com/2072-6694/18/22/3604
AB  - Objective: Development of second primary cancers (SPCs) is a significant risk for head and neck cancer (HNC) patients. This study investigates the impact of synchronous and metachronous SPCs on treatment strategies of newly diagnosed HNC. Methods: We retrospectively analyzed patients referred for curative-intent radiotherapy between 2022 and 2024. The primary outcome was the impact of SPCs on HNC (chemo)radiotherapy strategies, with SPC prevalence and distribution as secondary outcomes. Results: A total of 285 patients were included. In 28.4% an SPC was observed. A total of 8.4% had a synchronous malignancy, 16.5% were treated for another malignancy in the past and 3.5% presented with both a synchronous and metachronous cancer. The treatment was impacted in 37.0% of patients with an SPC. Treatment modifications included altered radiotherapy field (23.5%), treatment delays (13.6%), adjusted radio- or chemotherapy regimens (2.5% each), and transition to palliative care (1.2%). Conclusion: A substantial proportion of SPCs influenced the radiotherapy (RT) management in all domains. The complexity of treatment was further increased by the need for additional pre-treatment evaluations and consideration of prior therapies.
SN  - 2072-6694
ER  -