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(Radiology. 2000;216:197-205.)
© RSNA, 2000

Radiation Oncology

Sarcoma after Radiation Therapy: Retrospective Multiinstitutional Study of 80 Histologically Confirmed Cases1

Jean-Léon Lagrange, MD, PhD, Alain Ramaioli, PhD, Marie-Christine Chateau, MD, Christian Marchal, MD, Michel Resbeut, MD, Pierre Richaud, MD, Philippe Lagarde, MD, Patrice Rambert, MD, Jacques Tortechaux, MD, Sok Hun Seng, MD, Brigitte de la Fontan, MD, Monique Reme-Saumon, MD, Jacqueline Bof, RN, Jean-Pierre Ghnassia, MD and Jean-Michel Coindre, MD, PhD.For the Radiation Therapist and Pathologist Groups of the Fédération Nationale des Centres de Lutte Contre le Cancer

1 From the Radiation Oncology Department, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Nice 2, France (J.L.L.). Statistical Unit, Centre Antoine Lacassagne, Nice, France (A.R., J.B.); Surgical Pathology Department (M.C.C.) and Radiation Oncology Department (B.d.l.F.), Centre Claudius Regaud, Toulouse, France; Radiation Oncology Department, Centre Alexis Vautrin, Nancy, France (C.M.); Radiation Oncology Department, Institut Paoli-Calmettes, Marseille, France (M.R.); Radiation Oncology Department (P.Richaud, P.L.) and Surgical Pathology Department (J.M.C.), Fondation Bergonie, Bordeaux, France; Radiation Oncology Department, Centre René Huguenin, Saint-Cloud, France (P.Rambert); Radiation Oncology Department, Centre Jean-Perrin, Clermond-Ferrand (J.T.); Radiation Oncology Department, Centre Henri Becquerel, Rouen, France (S.H.S.); Radiation Oncology Department, Centre Paul Lamarque–Val D'Aurelle, Montpellier, France (M.R.S.); and Surgical Pathology Department, Centre Paul Strauss, Strasbourg, France (J.P.G.). From the 1998 RSNA scientific assembly. Received January 15, 1999; revision requested March 24; final revision received December 8; accepted December 21. Address correspondence to J.L.L. (e-mail: jean-leon.lagrange@cal.nice.fnclcc.fr).

PURPOSE: To evaluate the best strategy for treatment of sarcoma that occurs after radiation therapy.

MATERIALS AND 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.

CONCLUSION: The results confirm the beneficial effect of surgery. Further study is needed to explore the roles of combined treatments.

Index terms: Histiocytoma, **.322 • Leiomyosarcoma, **.32 • Lymphoma, **.32 • Osteosarcoma, 40.3221, 40.375 • Radiations, injurious effects, complications of therapeutic radiology • Sarcoma, **.32




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