Postradiation soft tissue sarcomas: An analysis of 53 cases

Abstract

The clinicopathologic features of 53 cases of postradiation soft tissue sarcoma (PRS) were correlated with the physical characteristics of the administered radiation. All but three patients received radiation for malignant processes. Of the secondary sarcomas, malignant fibrous histiocytoma (MFH) accounted for 36 cases (68%), followed by seven extraskeletal osteosarcomas (13%), six fibrosarcomas (ll%), two malignant Schwannomas (4%), one extraskeletal chondrosarcoma, and one angiosarcoma. The sex incidence, age of the patient at time of diagnosis, and location of the PRS correlated only with the clinical characteristics of the initial treated condition. The latency period (mean 10 years) showed an indefinite relationship to patient survival but no definite relationship to the patient's age at the time of the initial radiation. There was no difference between patients treated with megavoltage radiation (39 patients) and with or-thovoltage radiation (seven patients) in the type of sarcoma, location, or survival, although the orthovoltage group received a lower mean radiation dose (3880 rads) than the megavoltage group (4446 rads). Mega-voltage radiation, however, produced deeper tissue radiation changes and was associated with a shorter latency period. Most PRS were poorly differentiated, produced abundant collagen, and had a dismal prognosis. Cancer 622330-2340,1988. HERAPEUTIC RADIATION has long been recognized T as an inducing agent in the development of malignant neoplasms ever since 1902 when Frieben' reported a case of squamous cell carcinoma arising in the hand of an x-ray technician. Previous reports dealt primarily with postradiation carcinomas or bone tumors, but rarely with soft tissue sarcomas. However, as early as 1904, Perthes2 described a spindle cell sarcoma that followed radiation therapy for lupus. In 1907, Coenen' concluded that 12% of radiation-induced tumors were sarcomas, and one year later, Marie, Clunet, and Ravlot-LaPointe4 provided experimental proof by inducing sarcomas in irradiated rats. To date, only a few reports on postradiation sarcomas have attempted correlating the various radiobiologic parameters used in clinical practice with the development and histopathology of soft tissue ' The reasons for such a dearth of useful correlative information stem from the long latency period experienced with most post

Radiation‐induced osteosarcomas of the calvarium and skull base

“…2,9,20 The shortest latency period in our group was 4.5 years. Laskin et al 21 reported a link between shorter latency periods and worse outcomes with radiation-induced soft-tissue sarcomas, but this relationship has not been further substantiated in the literature. We did not find any significant correlation between latency period and survival in our series.…”

Radiation-induced Extra-osseous Osteosarcoma—A Case Report and Review of Literature

“…The incidence of radiation-associated EOO is reported in the literature in the range of 3.8 %-10 % of all EOO [7] and 13 % of all radiation induced sarcomas [13]. Pendlebury et al [14]reviewed the literature on radiation-associated sarcoma following radiotherapy for breast cancer.…”

Pleomorphic liposarcoma of a young woman following radiotherapy for epithelioid sarcoma

“…14 The amount of irradiation therapy received by patients with PRS has been reported to range between 1600 and 12440 cGy. 12,14,16 The most frequent histologic types of PRS are osteosarcoma, malignant fibrous histiocytoma and fibrosarcoma. 1,12 The most common primary tumors in the reviewed series of PRS-s are breast and female genital tract cancer, testicular cancer and Hodgkin's disease.…”

“…14 Histologically PRS are most frequently malignant fibrous histiocytomas, less frequently osteosarcomas, fibrosarcomas, malignant peripheral nerve sheath tumors or angiosarcoma. 12 PRS-s with other morphology than the above mentioned, such as liposarcoma, are extremely rare. 5 In the classic form, epithelioid sarcoma (ES) occurs in the distal parts of extremities of young adults as a slowly Keywords: epithelioid sarcoma, pleomorphic liposarcoma, postirradiation sarcoma growing, often multiple soft tissue neoplasm.…”

“…12 This rare complication of radiation therapy occurs in approximately 0,1% of patients, who undergo irradiation. 14 Histologically PRS are most frequently malignant fibrous histiocytomas, less frequently osteosarcomas, fibrosarcomas, malignant peripheral nerve sheath tumors or angiosarcoma.…”