Radiation-induced sarcoma: 25-year experience from The Norwegian Radium Hospital

Division of Pathology, Norwegian Radium Hospital, Rikshospitalet University Hospital, Oslo, Norway.
Acta oncologica (Stockholm, Sweden) (Impact Factor: 3). 05/2008; 47(8):1475-82. DOI: 10.1080/02841860802047387
Source: PubMed


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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    • "The median survival reported by Brady et al. [13] was one year, and the 5-year survival was 17% for patients with a tumour of more than 5 cm in diameter and not completely resected. Bjerkehagen et al. [27] noted 33% 5-year crude survival. Inoue [18] noted 5-year overall survival for patients with resectable lesion of the extremities at the level of 68.2% compared with 27.3% for those with central type (pelvis, head/neck, spine, scapula). "
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    • "(2) A latency period of at least 2 years since the radiotherapy. (3) Histology compatible with high-grade malignant leiomyosarcoma (LMS), malignant fibrous histiocytoma (MFH), angiosarcoma (AS), malignant peripheral nerve sheath tumour (MPNST) and osteosarcoma (OS) different from that of the index tumour (Bjerkehagen et al, 2008). The selection of histological subtypes was based on the most frequent histological subtypes occurring among RIS. "
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