Author(s)
Lindsey E. Moses MD
Janine M. Rotsides MD
Fiyinfolu O. Balogun MD
Mark S. Persky MD
Franco M. Muggia MD
Michael J. Persky MD
Affiliation(s)
New York University Langone Health
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should have greater awareness of and be able to describe the risk of secondary malignancy in the oral cavity following the use of pegylated liposomal doxorubicin. Objectives: Advances in cancer treatment have increased survival for many patients, prompting a need for greater recognition of the long term complications of treatment. Chemotherapy agents have the potential to induce carcinogenesis in normal cells and can increase the risk of secondary malignancy. Pegylated liposomal doxorubicin (PLD) used for treatment of recurrent ovarian cancer has been associated with the development of oral squamous cell carcinoma. Study Design: Retrospective case series. Methods: Retrospective review of oral cavity squamous cell carcinoma (SCC) in patients with recurrent ovarian cancer treated with PLD between 1997-2017 at a single institution. Results: Eight patients treated with PLD developed oral cavity SCC. The duration of PLD use ranged from 1.3-15 years (mean 5.8) and cumulative dose ranged from 45-3000 mg/m2 (mean 1542). Seven patients tested positive for BRCA mutations (4 BRCA 1+, 3 BRCA 2+). No patients had a history of alcohol or tobacco use. All had early stage oral cavity disease, five were T1N0, two were T2N0, and one had carcinoma in situ. All patients underwent surgery, two received adjuvant radiation. Four developed locoregional recurrence requiring additional treatment. One patient died from complications of oral SCC and one from recurrent ovarian carcinoma. Three patients were NED in the head and neck at last followup, one patient had metastatic ovarian cancer and one metastatic SCC of the skin. Conclusions: Long term PLD therapy may be associated with the development of oral cavity SCC. A high index of suspicion and routine head and neck examination should be included in followup for exposed patients.