title: The clinical and functional outcome for patients with radiation-induced soft tissue sarcoma.
abstract: BACKGROUND
  Radiation-induced soft tissue sarcomas (RI-STS) are rare, and it is believed that they are associated with a poor prognosis.The authors of this report compared the clinical and functional outcomes of adults who had extremity RI-STS with the outcomes of adults with sporadic STS.
  
  
  METHODS
  Forty-four patients who were diagnosed with RI-STS from 1989 to 2009 were identified from 4 prospectively collected databases. Patient demographics, surgical and adjuvant treatment parameters, and oncologic and functional outcomes were evaluated.
  
  
  RESULTS
  The median latent period from irradiation of the primary condition to RI-STS diagnosis was 16 years. The median radiotherapy dose used for the index condition was 45 gray. The median age at RI-STS diagnosis was 56 years. The most common primary diagnoses were breast cancer (36.4%) and lymphoma (34.1%). The most common RI-STS histologies were malignant fibrous histiocytoma (36.4%) and angiosarcoma (18.2%). Forty-two patients underwent surgery, 13 patients received adjuvant radiotherapy, and 8 patients received adjuvant chemotherapy. Systemic metastases occurred in 50% of treated patients (n = 21), and 26% (n = 11) developed local recurrence, the risk of which was lower among patients who received reirradiation (P = .043). The 5-year disease-free interval (DFI) and overall survival (OS) rates for patients with RI-STS who presented without metastasis were 36% and 44%, respectively. Patients who had International Union Against Cancer TNM stage III RI-STS had a significantly worse DFI compared with patients who had stage III sporadic STS (multivariate analysis, P = .051). Eighteen patients with RI-STS underwent functional assessment after surgery, and their results were comparable to those of patients with sporadic STS.
  
  
  CONCLUSIONS
  Despite aggressive surgical treatment, patients who have RI-STS remain at greater risk of both local and systemic recurrence compared with patients who have sporadic STS, but they can anticipate similar functional outcomes. Reirradiation can be relatively safe and effective if used properly.
authors: Mount Sinai Hospital, Toronto, Ontario, Canada.
authors: Soha
authors: S
authors: Riad
authors: David
authors: D
authors: Biau
authors: Ginger E
authors: GE
authors: Holt
authors: Joel
authors: J
authors: Werier
authors: Robert E
authors: RE
authors: Turcotte
authors: Peter C
authors: PC
authors: Ferguson
authors: Anthony M
authors: AM
authors: Griffin
authors: Colleen I
authors: CI
authors: Dickie
authors: Peter W
authors: PW
authors: Chung
authors: Charles N
authors: CN
authors: Catton
authors: Brian
authors: B
authors: O'sullivan
authors: Jay S
authors: JS
authors: Wunder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009381:Neoplasms, Radiation-Induced / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011879:Radiotherapy Dosage; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013997:Time Factors