Radiation-induced sarcoma: 25-year experience from the Norwegian Radium Hospital.
ABSTRACT The aim of this study was to determine the prevalence and outcome of radiation-induced sarcomas (RISs) among sarcoma patients referred to the Norwegian Radium Hospital (NRH).
Ninety patients were identified from the institutional sarcoma data base. Medical records and histological and cytological material from both primary and secondary tumours were reviewed.
RIS represented 3.0 % of the sarcomas in the data base. The median latency time from radiotherapy of the primary tumour to the diagnosis of RIS was 13.6 years (range 2.5-57.8 years). Gynaecological, breast and testicular cancers were the most common primary diagnoses. For the RISs 13 different histological types were identified including 25 malignant fibrous histiocytomas (28% of all) and 22 osteosarcomas (24%). The sarcoma-related 5-year crude survival was 33% (95 % CI 23-43 %). Unfavourable prognostic factors were metastases at presentation, incomplete surgery and presence of tumour necrosis.
Radiation-induced sarcoma is rare and harbours an aggressive clinical behaviour. Complete surgical resection is mandatory for cure.
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ABSTRACT: Radiation-induced sarcoma (RIS) is a rare, aggressive malignancy. Breast cancer survivors treated with radiotherapy constitute a large fraction of RIS patients. To evaluate evidenced-based practices for RIS treatment, we performed a systematic review of the published English-language literature. We performed a systematic keyword search of PubMed for original research articles pertaining to RIS of the breast. We classified and evaluated the articles based on hierarchical levels of scientific evidence. We identified 124 original articles available for analysis, which included 1,831 patients. No randomized controlled trials involving RIS patients were found. We present the best available evidence for the etiology, comparative biology to primary sarcoma, prognostic factors, and treatment options for RIS of the breast. Although the evidence to guide clinical practice is limited to single institutional cohort studies, registry studies, case-control studies, and case reports, we applied the available evidence to address clinically relevant questions related to best practice in patient management. Surgery with widely negative margins remains the primary treatment of RIS. Unfortunately, the role of adjuvant and neoadjuvant chemotherapy remains uncertain. This systematic review highlights the need for additional well-designed studies to inform the management of RIS.The Oncologist 02/2012; 17(3):405-18. · 4.10 Impact Factor
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ABSTRACT: Radiation-induced olfactory neuroblastoma (ONB) is an uncommon neoplasm that is generally associated with a poor prognosis. We describe a new case of olfactory neuroblastoma in a patient previously treated for astrocytoma with holocranial radiotherapy 9 years ago. We reviewed the medical records of four patients with radiation-induced olfactory neuroblastoma between 2001 and 2009. This work supports the idea that ONB can be induced by radiation. As radiotherapy is a standard treatment in other tumors, clinicians must be aware of the possibility of a second tumor induced by radiation.Oral and Maxillofacial Surgery 06/2011; 15(2):71-7.
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ABSTRACT: Radiotherapy is known to cause rarely various malignancies including leukemia, sarcoma, and thyroid and lung carcinoma. Post-radiation sarcomas account for 0.5-5.5% of all sarcomas; and include extra skeletal osteosarcoma, fibrosarcoma leiomyosarcoma, and malignant fibrous histiocytoma. Reports on post radiotherapy malignant fibrous histiocytoma in cervical cancer patients are rare. We present a case of 45-years-old female diagnosed with squamous cell carcinoma of the uterine cervix stage IIB; she underwent a radical hysterectomy with pelvic lymphadenectomy and postoperative radiotherapy and chemotherapy. Five years later, she presented with ulcerated nodular masses in right and left medial aspect of thigh. Cytological and histological diagnosis of the masses was malignant fibrous histiocytoma which was further confirmed by immunohistochemistry. Post-irradiation sarcoma must be considered in patients of carcinoma cervix treated with radiotherapy, when soft tissue mass is seen in the previously irradiated area. It should be differentiated from metastasis from primary tumor with the help of appropriate markers as it has a grave prognosis.Archives of Gynecology 10/2010; 283 Suppl 1:79-82. · 0.91 Impact Factor