title: Not all sarcomas developed in irradiated tissue are necessarily radiation-induced--spectrum of disease and treatment characteristics.
abstract: BACKGROUND
  Sarcomas in irradiated tissue (SITs) are often considered with second cancers, although they usually present distinct dose-response, genetic and clinical patterns. The contribution of radiation in SIT development is likely, but remains unproven in many cases.
  
  
  METHODS
  We reviewed the literature for published data on SITs.
  
  
  RESULTS
  SITs incidence ranged between 0.03% and 0.2%. Median latency was 15 years. Angiosarcoma was the second most common subtype after undifferentiated sarcomas of malignant fibrous histiocytoma (MFH). C-Myc overexpression can be used to identify radiation-induced angiosarcoma, and a recently described transcriptomic signature of genes involved in chronic oxidative stress and mitochondrial dysfunction may indicate radiation causality. Osteosarcomas were often associated with genetic predisposition. Five-year survival rates rarely exceeded 30% because the therapeutic possibilities were often limited by the first cancer. Chemotherapy response may differ from that of de novo sarcomas.
  
  
  CONCLUSIONS
  SITs present different characteristics from non-sarcomatoid second cancers. Reporting of SIT cases and the establishment of tissue and serum banks is necessary to better understand and validate the recently discovered radiation signature.
authors.affiliation: Department of Radiation Oncology/IBDC CNRS UMR 6543 Institut Universitaire de la Face et du Cou, Antoine-Lacassagne Cancer Center, Nice Sophia-Antipolis University, 33 Av. Valombrose, 06189 Nice Cedex 2, France. jthariat@hotmail.com
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Antoine
authors.initials: A
authors.lastname: Italiano
authors.forename: Fabrice
authors.initials: F
authors.lastname: Collin
authors.forename: Antoine
authors.initials: A
authors.lastname: Iannessi
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marcy
authors.forename: Alexis
authors.initials: A
authors.lastname: Lacout
authors.forename: Isabelle
authors.initials: I
authors.lastname: Birtwisle-Peyrottes
authors.forename: Antoine
authors.initials: A
authors.lastname: Thyss
authors.forename: Jean-Léon
authors.initials: JL
authors.lastname: Lagrange
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D012509:Sarcoma / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy*