Sarcoma after radiation therapy: retrospective multiinstitutional study of 80 histologically confirmed cases. Radiation Therapist and Pathologist Groups of the Fédération Nationale des Centres de Lutte Contre le Cancer.
OBJECTIVE
To evaluate the best strategy for treatment of sarcoma that occurs after radiation therapy.


METHODS
Records were retrospectively reviewed for 80 patients with a confirmed histologic diagnosis of sarcoma that occurred after radiation therapy performed during 1975-1995. The patients were treated for breast cancer (n = 33, 42%), non-Hodgkin lymphoma (n = 9, 11%), cervical cancer (n = 9, 11%), benign lesions (n = 4, 5%), or other tumors (n = 25, 31%). Sarcoma occurred after a mean latency of 12 years (range, 3-64 years), with most (70%) developing in the soft tissue. Treatment included surgery (28 patients), surgery and chemotherapy (18 patients), chemotherapy only (15 patients), and radiation therapy (14 patients).


RESULTS
By the end of the study, 51 patients were dead, including 46 due to sarcoma. Median survival was 23 months. Overall survival rates at 2 and 5 years, respectively, were 69% and 39% for patients treated with surgery, 10% and 0% for those treated with chemotherapy, and 52% and 35% for those treated with surgery and chemotherapy (P =.001). The 2- and 5-year rates for survival without recurrence were 54% and 32%, respectively.


CONCLUSIONS
The results confirm the beneficial effect of surgery. Further study is needed to explore the roles of combined treatments.
Lagrange
J L
JL
Radiation Oncology Department, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Nice 2, France. jean-leon.lagrange@cal.nice.fnclcc.fr
Ramaioli
A
A
Chateau
M C
MC
Marchal
C
C
Resbeut
M
M
Richaud
P
P
Lagarde
P
P
Rambert
P
P
Tortechaux
J
J
Seng
S H
SH
de la Fontan
B
B
Reme-Saumon
M
M
Bof
J
J
Ghnassia
J P
JP
Coindre
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012509:Sarcoma / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D015996:Survival Rate