Cancer Res Treat.  2016 Apr;48(2):650-657. 10.4143/crt.2015.171.

Radiation-Induced Sarcoma: A 15-Year Experience in a Single Large Tertiary Referral Center

• Kim KS
• Chang JH
• Choi N
• Kim HS
• Han I
• Moon KC
• Kim IH
• Kim HJ

• KMID: 2454343
• DOI: http://doi.org/10.4143/crt.2015.171

Abstract

PURPOSE
The purpose of this study is to report on the incidence and the experience in management of radiation-induced sarcoma (RIS) at a large single center in Korea for 15 years.
MATERIALS AND METHODS
We retrospectively reviewed the sarcoma registry of a large institution from January 2000 to April 2014.
RESULTS
Out of the 3,674 patients listed in the registry, 33 patients (0.9%) diagnosed with RIS were identified. The median latency of RIS was 12.1 years. The number of cases of RIS increased from four cases in the years 2000-2003 to 14 cases in the years 2012-2014. The most common histology was osteosarcoma (36.4%). The median follow-up period was 23.1 months, the median overall survival (OS) of all patients was 2.9 years, and their 5-year survival rate was 44.7%. Univariate and multivariate analyses showed association of the age at diagnosis (p=0.01) and the treatment aim (p=0.001) with the OS. The median OS and the 5-year survival rate of patients treated with curative surgery (n=19) were 9.6 years and 65%, respectively, and of the conservatively treated patients, 0.7 years and 0% (n=14). Re-irradiation was delivered to nine patients, and radiation toxicity was observed in five patients.
CONCLUSION
In this study, RIS accounted for 0.9% of the cases of sarcoma, with increasing incidence. Despite the association of curative resection with increased survival, it could be applied to only 58% of the patients. Considering the limited treatment options for RIS, conduct of a genetic study to identify the underlying mechanism of RIS is needed.

Keyword

Radiation-induced neoplasms; Sarcoma; Survival

MeSH Terms

Diagnosis
Follow-Up Studies
Humans
Incidence
Korea
Multivariate Analysis
Neoplasms, Radiation-Induced
Osteosarcoma
Re-Irradiation
Retrospective Studies
Sarcoma*
Survival Rate
Tertiary Care Centers*

Figure

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  Fig. 1. Incidence of radiation induced sarcoma in a tertiary referral center in Korea. Numbers in parentheses denote the radiation-induced sarcoma (RIS) cases per all sarcoma patients in given periods

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  Fig. 2. Overall survival of patients with radiation induced sarcoma.

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  Fig. 3. Summary of treatment outcome of patients with radiation-induced sarcoma. NED, no evidence of disease.

Reference

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