Clinicopathologic features and treatment of postirradiation sarcoma of bone and soft tissue

Inoue, Yoshiya; Frassica, Frank J.; Sim, Franklin H.; Unni, K. Krishnan; Petersen, Ivy A.; McLeod, Richard A.

doi:10.1002/1096-9098(200009)75:1<42::aid-jso8>3.0.co;2-g

Cited by 89 publications

(95 citation statements)

References 44 publications

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“…9,30 Our results suggest that this difference may be caused at least in part by the lower dose given to the patients who received orthovoltage radiation. Our study also suggested that the latency of RIS after megavoltage x-ray therapy was not only shorter than that after orthovoltage x-ray therapy but also was shorter than the latency after Cobalt-60 therapy.…”

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 82%

“…[18][19][20][21]29 In our study, we used the most common latency criteria of 3 to 4 years as reported by Arlen et al 21 The median latency in our series, 9.3 years, was consistent with data from other studies, in which the median latency ranges from 7.6 years to 22 years. [3][4][5][6][7][8][9][10][11]29 The shorter period of 7.6 years reported by Kuttesch et al 26 may be explained by the younger age of their patients. In addition, the administration of chemotherapy may shorten the interval between RT for the first cancer and the subsequent presentation of RIS.…”

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

“…These results contrast with previous studies in which malignant fibrous histiocytoma and osteosarcoma reportedly were the most frequent types. 4,9,29 The histologic subtype of RIS may be related to the primary tumor type and other risk factors. For instance, Kirova et al 6 reported that angiosarcoma was the most frequent subtype of RIS to develop after breast carcinoma treatment by irradiation.…”

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

“…The 3-year OS rate for patients with RIS in our series (32.4%) was within the lower end of the wide range reported previously (8%-60% at 5 years). [3][4][5][6][7][8][9][10][11][12][13]34 The best survival outcome was reported by Tabone et al, 35 who reported that the OS and eventfree survival rates for 23 patients with radiation-related osteosarcoma at 8 years were 50% and 41%, respectively.…”

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

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Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

Liu

Wang

et al. 2010

Cancer

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BACKGROUND:The increasing incidence of radiation-induced sarcoma (RIS) has become a significant problem that can limit long-term survival. The objective of the current study was to analyze the clinicopathologic characteristics, treatment outcomes, and prognostic factors of RIS after radiotherapy for nasopharyngeal carcinoma (NPC). METH-ODS: Institutional electronic medical records of patients with NPC who received definitive radiotherapy between February 1964 and 2003 were reviewed. Fifty-three patients who developed RIS and fulfilled the study criteria were included. RESULTS: The median follow-up after a diagnosis of RIS was 15.5 months (range, 0.4-90.3 months), and the median latency between radiotherapy for NPC and an RIS diagnosis was 9.3 years (range, 3.2-26.6 years). Fibrosarcoma was the most frequent histologic type observed, followed by osteosarcoma, and malignant fibrous histiocytoma. The 3-year overall survival (OS) rate for 49 patients who received treatment was 32.4%, and the median survival was 21.2 months (95% confidence interval, 8.7-33.8 months). The median OS was 41.3 months, 8.4 months, and 11 months for the complete resection group, the incomplete resection group, and the chemotherapy group, respectively (P<.0001). The only independent predictive factor that was associated with better OS was complete surgical resection. CONCLUSIONS: This retrospective study confirmed the rarity and poor prognosis of RIS in patients with NPC. Complete surgical resection was a significant prognostic factor for survival. The authors concluded that long-term follow-up is necessary for the early detection of RIS in patients with NPC. Cancer 2010;116:5479-86.

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Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 82%

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

See 2 more Smart Citations

Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

Liu

Wang

et al. 2010

Cancer

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“…High-grade osteosarcoma, fibrosarcoma and malignant fibrous histiocytoma are the most common histologic types of radiationinduced sarcomas. The mean latency period ranges from 14 to 17 years (although some have occurred as soon as 3 years after RT), and the tumors are usually radioresistant [32,35]. RT-induced sarcomas were initially considered to have a grave prognosis compared with primary bone sarcoma, but subsequent studies have shown that aggressive treatment with chemotherapy and surgical resection improves the prognosis of RT-induced sarcomas, resulting in more than a 60% 5-year survival rate-approaching that of a primary bone sarcoma (50-80% 5-year survival rate) [33,35].…”

Section: Post-treatment Changesmentioning

confidence: 99%

Magnetic resonance imaging of bone marrow in oncology, Part 2

Hwang

Panicek

2007

Skeletal Radiol

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Magnetic resonance imaging plays an integral role in the detection and characterization of marrow lesions, planning for biopsy or surgery, and post-treatment followup. To evaluate findings in bone marrow on MR imaging, it is essential to understand the normal composition and distribution of bone marrow and the changes in marrow that occur with age, as well as the basis for the MR signals from marrow and the factors that affect those signals; these points have been reviewed and illustrated in part 1 of this two-part article. Part 2 will emphasize the practical application of MR imaging to facilitate differentiation of normal marrow, tumor, and treatment-related marrow changes in oncology patients, and will review complementary MR techniques under development.

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The clinical and functional outcome for patients with radiation‐induced soft tissue sarcoma

Riad

Biau

Holt

et al. 2011

Cancer

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BACKGROUND: Radiation-induced soft tissue sarcomas (RI-STS) are rare, and it is believed that they are associated with a poor prognosis. The authors of this report compared the clinical and functional outcomes of adults who had extremity RI-STS with the outcomes of adults with sporadic STS. METHODS: Forty-four patients who were diagnosed with RI-STS from 1989 to 2009 were identified from 4 prospectively collected databases. Patient demographics, surgical and adjuvant treatment parameters, and oncologic and functional outcomes were evaluated. RESULTS: The median latent period from irradiation of the primary condition to RI-STS diagnosis was 16 years. The median radiotherapy dose used for the index condition was 45 gray. The median age at RI-STS diagnosis was 56 years. The most common primary diagnoses were breast cancer (36.4%) and lymphoma (34.1%). The most common RI-STS histologies were malignant fibrous histiocytoma (36.4%) and angiosarcoma (18.2%). Forty-two patients underwent surgery, 13 patients received adjuvant radiotherapy, and 8 patients received adjuvant chemotherapy. Systemic metastases occurred in 50% of treated patients (n ¼ 21), and 26% (n ¼ 11) developed local recurrence, the risk of which was lower among patients who received reirradiation (P ¼ .043). The 5-year disease-free interval (DFI) and overall survival (OS) rates for patients with RI-STS who presented without metastasis were 36% and 44%, respectively. Patients who had International Union Against Cancer TNM stage III RI-STS had a significantly worse DFI compared with patients who had stage III sporadic STS (multivariate analysis, P ¼ .051). Eighteen patients with RI-STS underwent functional assessment after surgery, and their results were comparable to those of patients with sporadic STS. CONCLUSIONS: Despite aggressive surgical treatment, patients who have RI-STS remain at greater risk of both local and systemic recurrence compared with patients who have sporadic STS, but they can anticipate similar functional outcomes. Reirradiation can be relatively safe and effective if used properly. Cancer 2012;118:2682-

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Clinicopathologic features and treatment of postirradiation sarcoma of bone and soft tissue

Abstract: The prognosis for patients with peripheral resectable postirradiation sarcomas is good if a wide surgical margin can be achieved. This group of patients should be treated aggressively because they have a new cancer.

Cited by 89 publications

References 44 publications

Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

Magnetic resonance imaging of bone marrow in oncology, Part 2

The clinical and functional outcome for patients with radiation‐induced soft tissue sarcoma

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