Subsequent cancer in patients with Ewing's sarcoma.
Among 31 long-term survivors of Ewing's sarcoma, two patients developed second primary cancers, compared to an expected number of 0.03 (relative risk = 72; 95% confidence limit = 8-259). One patient had renal medullary neuroblastoma, which is not known to be related to Ewing's tumor or its therapy. The second patient had a bone fibrosarcoma, arising at the primary tumor site, which was thought to be radiation-induced. The risk of radiation-induced bone sarcomas was lower, although not significantly so, than in a recently reported series of Ewing's tumor. These two reports suggest that patients with Ewing's sarcoma have a tendency to develop radiogenic sarcomas following primary megavoltage radiation therapy. The lowest radiation dose consistent with local tumor eradication should be employed to minimize the risk of subsequent radiogenic cancer.
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000209:etiology / Q000532:radiotherapy*; D002648:Child; D005260:Female; D005354:Fibrosarcoma / Q000209:etiology; D006801:Humans; D007680:Kidney Neoplasms / Q000209:etiology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000209:etiology*; D009381:Neoplasms, Radiation-Induced; D009447:Neuroblastoma / Q000209:etiology; D011882:Radiotherapy, High-Energy; D012306:Risk; D012512:Sarcoma, Ewing / Q000532:radiotherapy*