AI Article Synopsis
- Radiation-induced sarcomas (RIS) are rare and aggressive tumors that can complicate treatment decisions due to their unique characteristics and origins in previously irradiated tissues.
- A retrospective study using the CanSaRCC database analyzed RIS cases from 1996 to 2021, looking specifically at patient demographics, treatment, and outcomes across different sarcoma types.
- Among the 107 identified RIS tumors, breast angiosarcoma (BAS) was most common and associated with specific clinical trends, including a younger age for osteosarcoma patients and varying time intervals since initial cancer treatment.
Article Abstract
Background: Radiation-induced sarcomas (RIS) tend to have aggressive behaviour and because of their rarity, the most appropriate management for these malignancies is uncertain.
Objectives: Using the Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC) database, a national sarcoma registry, we aimed to investigate prognostic factors and outcomes for RIS.
Design: Retrospective study of RIS patients treated from 1996 to 2021 at three Canadian centres.
Methods: RIS was defined as a sarcoma arising in a previously irradiated field following a 3+ year latency period, whose histology was distinct from the initially irradiated tumour. Clinicopathologic and treatment-related information was extracted from the CanSaRCC database. Overall survival (OS) was defined as the time from RIS diagnosis to death from any cause. Response rate (RR) to neoadjuvant chemotherapy (NACT) was based on physician assessment. Time-to-event analyses were estimated using the Kaplan-Meier method, with Cox regression for multivariate analysis. We considered a two-tailed -value of <0.05 as statistically significant.
Results: One hundred seven tumours met the criteria for RIS and were divided into three subgroups: breast angiosarcoma (BAS, = 54), osteosarcoma (OST, = 16), and other soft-tissue sarcomas (STS, = 37). Patients were mostly female ( = 85, 79%), treated initially for breast carcinomas ( = 54, 50.5%), and diagnosed with high-grade tumours ( = 61/71, 86%). None had evidence of synchronous metastasis. Patients with OST were younger (median age: 48 years, < 0.001), and BAS had the shortest latency interval (8 18 years for OST/STS, < 0.001). Most patients underwent surgery, 76% ( = 76/100) R0; 24% ( = 26) received radiation therapy, mostly ( = 15, 57.7%) neoadjuvant. Among those receiving chemotherapy, 30 (75%) underwent NACT; among patients with documented response assessment, the RR was 68% ( = 17/25), being even higher in the BAS population (89.5%, = 13/17). Median OS was 53 months (95% CI 34-101), with a 5-year OS of 47.6%; larger tumour size, high histologic grade and older age were independent prognostic factors for worse OS.
Conclusion: Surgery is standard, and NACT might be useful to downsize large lesions, especially in BAS patients. Raising RIS awareness is fundamental to promoting appropriate management and fostering research through multi-institutional collaborations.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540571 | PMC |
| http://dx.doi.org/10.1177/17588359231198943 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Role of vascularised fibula graft in the surgical management of radiation-induced midshaft femoral fractures. Case report and literature review.
World J Surg Oncol
December 2024
Department of Orthopaedic Surgery, Sarcoma Unit, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
Background: Post-radiation fractures (PRF) are a recognised complication of radiation treatment for soft tissue sarcomas. They have a low incidence and typically occur up to 5 years following treatment, more commonly affecting the pelvis, ribs and femur. Due to radiation-induced changes in bone, PRFs typically require more complicated intervention compared to post-trauma fractures, however, limited literature exists, particularly in regards to mid-shaft femoral PRFs.
View Article and Find Full Text PDFSecondary Osteosarcoma After Carbon-Ion Radiotherapy for Desmoid-Type Fibromatosis: A Case Report.
Cancer Rep (Hoboken)
November 2024
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Background: Radiotherapy is considered an alternative treatment for unresectable or pharmacologically resistant desmoid-type fibromatosis. While it results in relatively good local control, the risk of secondary malignancy remains a concern.
Case: We present a case of secondary osteosarcoma after carbon-ion radiation therapy (CIRT).
Perianal leiomyosarcoma as a rare sequela of rectal cancer radiotherapy: a case report.
Front Oncol
November 2024
Department of Pathology, Central Hospital of Guangdong Provincial Nongken, Zhanjiang, Guangdong, China.
Radiation-induced sarcomas (RIS) are iatrogenic malignancies that arise following high-dose radiotherapy, posing a significant clinical challenge due to their poor prognosis and resistance to conventional treatments. The incidence of RIS is increasing with advancements in radiotherapy techniques. This report presents a case of a 71-year-old male diagnosed with stage III rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and curative surgery.
View Article and Find Full Text PDFNeoadjuvant chemotherapy for radiation associated angiosarcoma (RAAS) of the breast: A retrospective single center study.
Breast
December 2024
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands. Electronic address:
Background: Radiation associated angiosarcoma (RAAS) of the breast is a rare malignancy with poor survival. Optimal treatment strategies remain uncertain due to a lack of data, and vary between surgery alone and a combination of surgery with (neo)adjuvant chemotherapy (NACT) and/or re-irradiation. The aim of this study was to evaluate the potential benefit of taxane based NACT.
View Article and Find Full Text PDFThe impact of fractionation on secondary malignancies in postoperative breast cancer irradiation.
Breast
December 2024
Department of Radiation Oncology, TUM School of Medicine and Health, TUM University Hospital, Klinikum rechts der Isar, Munich, Germany. Electronic address:
Article Synopsis
- Randomized studies suggest that (ultra-)hypofractionation is just as effective as a traditional 5-week radiation schedule for treating postoperative breast cancer, but there's limited data on its long-term impact on secondary cancers.
- A study involving 20 breast cancer patients examined different radiation schedules and found that (ultra-)hypofractionation significantly reduced the risk of secondary malignancies like lung cancer, contralateral breast cancer, and soft tissue sarcoma.
- The results indicated that using (ultra-)hypofractionation could lower the risk of developing secondary malignancies more than conventional scheduling, with varying effects based on the radiation technique (3D-CRT vs. VMAT).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!