title: Surgical Management of the Radiated Chest Wall and Its Complications.
abstract: Radiation to the chest wall is common before resection of tumors. Osteoradionecrosis can occur after radiation treatment. Radical resection and reconstruction can be lifesaving. Soft tissue coverage using myocutaneous or omental flaps is determined by the quality of soft tissue available and the status of the vascular pedicle supplying available myocutaneous flaps. Radiation-induced sarcomas of the chest wall occur most commonly after radiation therapy for breast cancer. Although angiosarcomas are the most common radiation-induced sarcomas, osteosarcoma, myosarcomas, rhabdomyosarcoma, and undifferentiated sarcomas also occur. The most effective treatment is surgical resection. Inoperable tumors are treated with chemotherapy, with low response rates.
authors.affiliation: Division of Thoracic Surgery, City of Hope, MOB 2001B, 1500 East Duarte Road, Duarte, CA 91010, USA. Electronic address: draz@coh.org.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Raz
authors.affiliation: Division of Plastic Surgery, City of Hope, MOB 2001B, 1500 East Duarte Road, Duarte, CA 91010, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Clancy
authors.affiliation: Division of Thoracic Surgery, City of Hope, MOB 2001B, 1500 East Duarte Road, Duarte, CA 91010, USA.
authors.forename: Loretta J
authors.initials: LJ
authors.lastname: Erhunmwunsee
mesh_terms: D001859:Bone Neoplasms / Q000209:etiology / Q000601:surgery; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000601:surgery*; D010025:Osteoradionecrosis / Q000209:etiology / Q000601:surgery*; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D019651:Plastic Surgery Procedures / Q000379:methods*; D000070602:Rib Cage / Q000601:surgery; D012509:Sarcoma / Q000209:etiology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps; D019616:Thoracic Surgical Procedures / Q000379:methods*; D035441:Thoracic Wall / Q000601:surgery*; D016896:Treatment Outcome
keywords: Breast cancer; Chest wall; Osteonecrosis; Radiation; Sarcoma