Post‐radiation sarcomas. Clinical outcome of 52 Patients

Mavrogenis, Andreas F.; Pala, Elisa; Guerra, Giovanni; Ruggieri, Pietro

doi:10.1002/jso.22122

Cited by 74 publications

(66 citation statements)

References 52 publications

(106 reference statements)

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“…We excluded patients with sarcomas originating in bone because evidence indicates that they have a different biology and survival than patients with STS. 13 A retrospective chart review was performed to extract clinical and pathologic information including patient age, date of sarcoma diagnosis, date of sarcoma resection, size of sarcoma, date of recurrence, and recurrence type (local/distant). For patients with RA-UPS/MFH, date of diagnosis for initial cancer, date of radiation, dose of radiation, and use of chemotherapy for primary malignancy were recorded.…”

Section: Methodsmentioning

confidence: 99%

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Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

et al. 2015

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Background Radiation therapy is used increasingly as a component of multidisciplinary treatment for many solid tumors. One complication of such treatment is the development of radiation-associated sarcoma (RAS). Undifferentiated pleomorphic sarcoma (UPS), previously termed “malignant fibrous histiocytoma” (MFH) is the most common histologic subtype of RAS. This study investigated the clinical outcomes for patients with radiation-associated UPS (RA-UPS/MFH). Methods The study identified 1068 patients with UPS/MFH treated at the authors’ institution. Patient and tumor factors were collected and compared. Regression analysis was performed to identify independent predictors of survival. A matched-cohort survival and recurrence analysis was performed for radiation-associated and sporadic UPS/MFH. Results The findings showed that RA-UPS/MFH comprised 5.1 % of the UPS population. The median latency to the development of RA-UPS/MFH was 9.3 years. The 5-year disease-specific survival (DSS) was 52.2 % for patients identified with RA-UPS/MFH (n = 55) compared with 76.4 % for patients with unmatched sporadic UPS/MFH (n = 1,013; p < 0.001). A matched-cohort analysis also demonstrated that the 5-year DSS was significantly worse for RA-UPS/MFH (52.2 vs 73.4 %; p = 0.002). Furthermore, higher local recurrence rates were observed for patients with RA-UPS/MFH than for patients with sporadic lesions (54.5 vs 23.5 %; p < 0.001). Radiation-associated status and incomplete resection were identified as independent predictors of local recurrence. Conclusion This study demonstrated worse clinical outcomes for patients with RA-UPS/MFH than for patients with sporadic UPS/MFH. Local recurrence was significantly higher for patients with RA-UPS/MFH, suggesting a unique tumor biology for this challenging disease.

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Section: Methodsmentioning

confidence: 99%

“…7,12 However, more recent evidence suggests that this period may be much shorter for soft tissue sarcoma (STS). 9,11 Whereas the latency period for bone sarcoma is reported to be as long as 15 years, 13 the latency period for STS is commonly reported to be 7–16 years. 8–10,14,15 …”

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confidence: 99%

Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

et al. 2015

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“…This risk is delayed by an average of approximately 15 years. 34,35 However, the ICRP method is explicitly not intended for prediction of risks from therapeutic radiation. 25 It provides an estimate of global population risk, irrespective of age.…”

Section: Estimating Risk From Radiotherapymentioning

confidence: 99%

Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk

Burnet

Nasr²,

Yip³

et al. 2014

BJR

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“…In addition, recent findings from studies on Japanese atomic bomb survivors have suggested that the risk of sarcomas is elevated by acute lower doses of radiation (<5 Gy) at any age 11. Osteosarcoma is the most common type of post- radiation sarcoma, followed by malignant fibrous histiocytoma and fibrosarcoma 14. The good absorption of radiation by bone may account for the high incidence of bone sarcoma relative to other sites.…”

Section: Epidemiologymentioning

confidence: 99%

Epidemiology and therapies for metastatic sarcoma

Amankwah¹,

Conley²,

Reed³

2013

CLEP

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Sarcomas are cancers arising from the mesenchymal layer that affect children, adolescents, young adults, and adults. Although most sarcomas are localized, many display a remarkable predilection for metastasis to the lungs, liver, bones, subcutaneous tissue, and lymph nodes. Additionally, many sarcoma patients presenting initially with localized disease may relapse at metastatic sites. While localized sarcomas can often be cured through surgery and often radiation, controversies exist over optimal management of patients with metastatic sarcoma. Combinations of chemotherapy are the most effective in many settings, and many promising new agents are under active investigation or are being explored in preclinical models. Metastatic sarcomas are excellent candidates for novel approaches with additional agents as they have demonstrated chemosensitivity and affect a portion of the population that is motivated toward curative therapy. In this paper, we provide an overview on the common sarcomas of childhood (rhabdomyosarcoma), adolescence, and young adults (osteosarcoma, Ewing sarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumor) and older adults (leiomyosarcoma, liposarcoma, and undifferentiated high grade sarcoma) in terms of the epidemiology, current therapy, promising therapeutic directions and outcome with a focus on metastatic disease. Potential advances in terms of promising therapy and biologic insights may lead to more effective and safer therapies; however, more clinical trials and research are needed for patients with metastatic sarcoma.

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Post‐radiation sarcomas. Clinical outcome of 52 Patients

Abstract: Prognosis of post-radiation sarcomas is poor; the type of the sarcomas is the only significant variable for survival.

Cited by 74 publications

References 52 publications

Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

Radiation-Associated Undifferentiated Pleomorphic Sarcoma is Associated with Worse Clinical Outcomes than Sporadic Lesions

Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk

Epidemiology and therapies for metastatic sarcoma

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