1
|
Vankipuram S, Jaiswal M, Singh SK, Qayoo S, Ojha BK. Radiation-induced Supratentorial Osteosarcoma Following Curative Treatment of Infratentorial Ependymoma in a Child. J Pediatr Neurosci 2020; 15:304-307. [PMID: 33531953 PMCID: PMC7847095 DOI: 10.4103/jpn.jpn_8_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/19/2020] [Accepted: 04/03/2020] [Indexed: 12/03/2022] Open
Abstract
The development of secondary neoplasms following therapeutic cranial irradiation is rare and quite often lethal. Meningiomas, sarcomas, and high-grade gliomas are the most common tumors that manifest as a result of radiation therapy. We report the case of an 11-year-old child who presented with symptoms of supratentorial space-occupying lesion 7 years after curative surgery and cranial irradiation for a posterior fossa ependymoma. Magnetic resonance imaging of the brain revealed a right-sided temporoparietal dural-based contrast-enhancing lesion with evidence of overlying bone and skin involvement. The histological report of ependymoma from the previous surgery led us to suspect that we were dealing with a recurrence until the histopathology of the second surgery revealed highly malignant osteosarcoma. The child recovered fully and underwent chemotherapy, but ultimately succumbed to the disease. We report this case to highlight the importance of recognizing these neoplasms and to review its management.
Collapse
Affiliation(s)
- Siddharth Vankipuram
- Department of Neurosurgery, Shatabdi Hospital Phase 2, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Manish Jaiswal
- Department of Neurosurgery, Shatabdi Hospital Phase 2, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Sunil K Singh
- Department of Neurosurgery, Apollo Hospital, Lucknow, Uttar Pradesh, India
| | - Sumaira Qayoo
- Department of Pathology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Bal K Ojha
- Department of Neurosurgery, Shatabdi Hospital Phase 2, King George Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
2
|
Yamanaka R, Hayano A. Secondary Craniofacial Sarcomas Following Retinoblastoma: A Systematic Review. World Neurosurg 2017; 101:722-730.e4. [PMID: 28214635 DOI: 10.1016/j.wneu.2017.02.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/02/2017] [Accepted: 02/06/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We conducted the largest systematic review of individual patient data to characterize secondary craniofacial sarcomas following retinoblastoma. METHODS We conducted a systemic search of the PubMed databases and compiled a comprehensive literature review. Student t tests were used to evaluate differences between variables. Kaplan-Meier analysis was used to estimate survival. Statistical significance was assessed using a log-rank test. RESULTS We analyzed 220 cases of secondary craniofacial sarcomas, including 112 osteosarcomas. The average age (±SD) of onset for retinoblastoma was 1.20 ± 2.77 years. External-beam radiotherapy was delivered in 207 patients (94.0%) and chemotherapy was delivered in 53 patients (24.0%) patients. The latency period between retinoblastoma diagnosis and the onset of secondary sarcomas was 12 years. Cranial extension was found in 66 patients (30.0%). The median overall survival was worse with cranial extension (P = 0.0073). In cranial extended patients, the median survival in patients who received chemotherapy was 41 months, whereas patients who did not receive chemotherapy had a median survival of 12 months (P = 0.0020). CONCLUSIONS The risk of incidence of secondary sarcomas in retinoblastoma patients warrants longer follow-up periods. Moreover, chemotherapy should be considered as a potential treatment option for secondary cranial sarcomas following retinoblastoma.
Collapse
Affiliation(s)
- Ryuya Yamanaka
- Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Azusa Hayano
- Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
3
|
Yamanaka R, Hayano A. Radiation-Induced Sarcomas of the Central Nervous System: A Systematic Review. World Neurosurg 2017; 98:818-828.e7. [DOI: 10.1016/j.wneu.2016.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023]
|
4
|
Echchikhi Y, Loughlimi H, Touil A, Kebdani T, Benjaafar N. Radiation-induced osteosarcoma of the skull base after radiation therapy in a patient with nasopharyngeal carcinoma: a case report and review of the literature. J Med Case Rep 2016; 10:334. [PMID: 27906102 PMCID: PMC5133737 DOI: 10.1186/s13256-016-1112-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/23/2016] [Indexed: 01/09/2023] Open
Abstract
Background Radiation-induced osteosarcomas are a recognized complication of radiation therapy. Owing to the fact that it is rare, publications on radiation-induced osteosarcoma of the skull base are limited to a small series and some case reports. Case presentation We describe a rare case of a patient with a skull base radiation-induced osteosarcoma treated 11 years before with ionizing radiation for an undifferentiated carcinoma of the nasopharynx. The patient was treated with chemotherapy alone, but he died after the third cycle. Conclusions Radiation-induced osteosarcoma of the skull base after treatment of nasopharyngeal carcinoma is a very rare but very aggressive complication with a poor prognosis. Chemotherapy gives bad results, and regular follow-up of treated patients should be considered.
Collapse
Affiliation(s)
- Yassine Echchikhi
- Department of Radiation Oncology, National Institute of Oncology, University Mohamed 5, Ibn Sina Center, Allal El Fassi Boulevard, Rabat, Morocco.
| | - Hasna Loughlimi
- Department of Radiation Oncology, National Institute of Oncology, University Mohamed 5, Ibn Sina Center, Allal El Fassi Boulevard, Rabat, Morocco
| | - Asmae Touil
- Department of Radiation Oncology, National Institute of Oncology, University Mohamed 5, Ibn Sina Center, Allal El Fassi Boulevard, Rabat, Morocco
| | - Tayeb Kebdani
- Department of Radiation Oncology, National Institute of Oncology, University Mohamed 5, Ibn Sina Center, Allal El Fassi Boulevard, Rabat, Morocco
| | - Noureddine Benjaafar
- Department of Radiation Oncology, National Institute of Oncology, University Mohamed 5, Ibn Sina Center, Allal El Fassi Boulevard, Rabat, Morocco
| |
Collapse
|
5
|
Marta GN, Murphy E, Chao S, Yu JS, Suh JH. The incidence of second brain tumors related to cranial irradiation. Expert Rev Anticancer Ther 2014; 15:295-304. [PMID: 25482749 DOI: 10.1586/14737140.2015.989839] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Secondary brain tumor (SBT) is a devastating complication of cranial irradiation (CI). We reviewed the literature to determine the incidence of SBT as related to specific radiation therapy (RT) treatment modalities. The relative risk of radiation-associated SBT after conventional and conformal RT is well established and ranges from 5.65 to 10.9; latent time to develop second tumor ranges from 5.8 to 22.4 years, depending on radiation dose and primary disease. Theories and dosimetric models suggest that intensity-modulated radiation therapy may result in an increased risk of SBT, but clinical evidence is limited. The incidence of stereotactic radiosurgery-related SBT is low. Initial data suggest that no increased risk from proton therapy and dosimetric models predict a lower incidence of SBT compared with photons. In conclusion, the incidence of SBT related to CI is low. Longer follow-up is needed to clarify the impact of intensity-modulated radiation therapy, proton therapy and other developing technologies.
Collapse
Affiliation(s)
- Gustavo Nader Marta
- Radiation Oncology Department, Hospital Sírio-Libanês, Rua Dona Adma Jafet 91., Sao Paulo, Sao Paulo 01308-050, Brazil
| | | | | | | | | |
Collapse
|
6
|
Sai K, Mou YG, Zeng J, Lv YC, Xi SY, Guan S, Zhang XH, Wang J, Ke C, Guo JG, Chen YS, Chen ZP. Neurosurgical interventions for patients with nasopharyngeal carcinoma: a single institution experience. World J Surg Oncol 2013; 11:227. [PMID: 24034781 PMCID: PMC3847299 DOI: 10.1186/1477-7819-11-227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 09/03/2013] [Indexed: 12/18/2022] Open
Abstract
Background Nasopharyngeal carcinoma (NPC) is a frequent head and neck cancer in southern China and Southeast Asia. The majority of NPC patients are managed by radiation oncologists, medical oncologists and head and neck surgeons. Actually, neurosurgical interventions are warranted under specific circumstances. In this article, we described our experience as neurosurgeons in the management of NPC patients. Methods Medical records of NPC patients who received neurosurgical procedure at Sun Yat-sen University Cancer Center were reviewed. Results Twenty-seven patients were identified. Among 27 cases, neurosurgical procedures were performed in 18 (66.7%) with radiation-induced temporal necrosis, 2 (7.4%) with radiation-induced sarcoma, 4 (14.8%) with synchronous NPC with primary brain tumors, 2 (7.4%) with recurrent NPC involving skull base, and 1 (3.7%) with metachronous skull eosinophilic granuloma, respectively. The diagnosis is challenging in specific cases and initial misdiagnoses were found in 6 (22.2%) patients. Conclusions For NPC patients with intracranial or skull lesions, the initial diagnosis can be occasionally difficult because of the presence or a history of NPC and related treatment. Unawareness of these entities can result in misdiagnosis and subsequent improper treatment. Neurosurgical interventions are necessary for the diagnosis and treatment for these patients.
Collapse
Affiliation(s)
- Ke Sai
- Department of Neurosurgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Ghuangzhou 510060, China.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Yamada SM, Ishii Y, Yamada S, Kuribayashi S, Kumita S, Matsuno A. Advanced therapeutic strategy for radiation-induced osteosarcoma in the skull base: a case report and review. Radiat Oncol 2012; 7:136. [PMID: 22883312 PMCID: PMC3576274 DOI: 10.1186/1748-717x-7-136] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 07/07/2012] [Indexed: 11/10/2022] Open
Abstract
A review of patients with skull base osteosarcoma secondary to radiation (radiation-induced osteosarcoma: RIOS) of the pituitary tumor shows the mean survival of approximately 7 months (2 weeks-16 months). This warning prognosis seems to stem from two factors, 1) the anatomical complexity of the skull base for total resection of the tumor, and 2) standard adjuvant therapies for the tumor yet to be established. Contrary to the general belief, the authors report an unusually long survival of a 75-year-old woman with a history of osteosarcoma that developed in the same sequence 20 years after pituitary tumor radiation. On her recent admission, she complained of frontal headaches and MRI studies showed a tumor in the sphenoid sinus. Endoscopic trans-nasal tumor removal allowed for histological diagnosis of an osteosarcoma. However, further rapid tumor growth necessitated a radical tumor resection followed by a combined chemotherapy with ifosfamide, cisplatin, and etoposide (ICE). Despite temporary suppression of the tumor growth, the chemotherapy was discontinued due to severe pancytopenia that occurred after three courses of treatment. Shortly after the discontinuation of ICE therapy, the tumor size increased again rapidly, requiring a novel radiation therapy, Cyber-knife treatment. Following this radiation, the tumor growth was arrested, and the patient remains healthy without neurological symptoms over 24 months. The outcome of Cyber-knife in this case suggests that this specific therapy must be considered for the unresectable skull base RIOS.
Collapse
Affiliation(s)
- Shoko Merrit Yamada
- Department of Neurosurgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba 299-0111, Japan.
| | | | | | | | | | | |
Collapse
|
8
|
Chowdhary A, Spence AM, Sales L, Rostomily RC, Rockhill JK, Silbergeld DL. Radiation associated tumors following therapeutic cranial radiation. Surg Neurol Int 2012; 3:48. [PMID: 22629485 PMCID: PMC3356990 DOI: 10.4103/2152-7806.96068] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 04/11/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND A serious, albeit rare, sequel of therapeutic ionizing radiotherapy is delayed development of a new, histologically distinct neoplasm within the radiation field. METHODS We identified 27 cases, from a 10-year period, of intracranial tumors arising after cranial irradiation. The original lesions for which cranial radiation was used for treatment included: tinea capitis (1), acute lymphoblastic leukemia (ALL; 5), sarcoma (1), scalp hemangioma (1), cranial nerve schwannoma (1) and primary (13) and metastatic (1) brain tumors, pituitary tumor (1), germinoma (1), pinealoma (1), and unknown histology (1). Dose of cranial irradiation ranged from 1800 to 6500 cGy, with a mean of 4596 cGy. Age at cranial irradiation ranged from 1 month to 43 years, with a mean of 13.4 years. RESULTS Latency between radiotherapy and diagnosis of a radiation-induced neoplasm ranged from 4 to 47 years (mean 18.8 years). Radiation-induced tumors included: meningiomas (14), sarcomas (7), malignant astrocytomas (4), and medulloblastomas (2). Data were analyzed to evaluate possible correlations between gender, age at irradiation, dose of irradiation, latency, use of chemotherapy, and radiation-induced neoplasm histology. Significant correlations existed between age at cranial irradiation and development of either a benign neoplasm (mean age 8.5 years) versus a malignant neoplasm (mean age 20.3; P = 0.012), and development of either a meningioma (mean age 7.0 years) or a sarcoma (mean age 27.4 years; P = 0.0001). There was also a significant positive correlation between latency and development of either a meningioma (mean latency 21.8 years) or a sarcoma (mean latency 7.7 years; P = 0.001). The correlation between dose of cranial irradiation and development of either a meningioma (mean dose 4128 cGy) or a sarcoma (mean dose 5631 cGy) approached significance (P = 0.059). CONCLUSIONS Our study is the first to show that younger patients had a longer latency period and were more likely to have lower-grade lesions (e.g. meningiomas) as a secondary neoplasm, while older patients had a shorter latency period and were more likely to have higher-grade lesions (e.g. sarcomas).
Collapse
Affiliation(s)
- Abhineet Chowdhary
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | | | | | | |
Collapse
|
9
|
Bacci G, Longhi A, Forni C, Fabbri N, Briccoli A, Barbieri E, Mercuri M, Balladelli A, Ferrari S, Picci P. Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases. Int J Radiat Oncol Biol Phys 2006; 67:505-11. [PMID: 17118571 DOI: 10.1016/j.ijrobp.2006.08.072] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Revised: 08/31/2006] [Accepted: 08/31/2006] [Indexed: 12/25/2022]
Abstract
PURPOSE Evaluate treatment and outcome of 20 patients with radioinduced osteosarcoma (RIO). Because of previous primary tumor treatment, RIO protocols were different from others we used for non-RIO. PATIENTS AND METHODS Between 1983 and 1998, we treated 20 RIO patients, ages 4-36 years (mean 16 years), with chemotherapy (two cycles before surgery, three postoperatively). The first preoperative cycle consisted of high-dose Methotrexate (HDMTX)/Cisplatinum (CDP)/Adriamycin (ADM) and the second of HDMTX/CDP/Ifosfamide (IFO). The three postoperative treatments were performed with cycles of MTX/CDP; IFO was used as single agent per cycle repeated three times. RESULTS Two patients received palliative treatment because their osteosarcoma remained unresectable after preoperative chemotherapy. The remaining 18 patients had surgery (7 amputations, 11 resections); histologic response to preoperative chemotherapy was good in 8 patients, poor in 10. At a mean follow-up of 11 years (range, 7-22 years), 9 patients remained continuously disease-free, 10 died from osteosarcoma and 1 died from a third neoplasm (myeloid acute leukemia). These results are not significantly different from those achieved in 754 patients with conventional osteosarcoma treated in the same period with protocols used for conventional treatment. However, this later group had an 18% 3-year event-free survival after treatment of relapse vs. 0% in the RIO group. CONCLUSION Treated with neoadjuvant chemotherapy RIO seem to have an outcome that is not significantly different from that of comparable patients with conventional primary high grade osteosarcoma (5-year event-free survival: 40% vs. 60%, p = NS; 5-year overall survival 40% vs. 67%, p < 0.01).
Collapse
Affiliation(s)
- Gaetano Bacci
- Sections of Chemotherapy, Istituti Ortopedici Rizzoli, Bologna, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Teo WY, Tan HKK, Goh BC, Putti TC. Postirradiation Sarcoma of the Sphenoid Bone – A Case Report. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2006. [DOI: 10.47102/annals-acadmedsg.v35n2p104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Introduction: The development of secondary tumours as a result of radiation therapy is a rare but serious complication.
Clinical Picture: This is a case report of a 45-year-old Chinese male who developed postirradiation sarcoma of the sphenoid bone in less than 5 years after radiation therapy for Stage T3N1M0 nasopharyngeal carcinoma.
Discussion: In the literature, the only case of postirradiation osteosarcoma of the sphenoid bone was after radiation therapy for craniopharyngioma. There was no previously reported case of postirradiation sarcoma of the sphenoid bone after radiation therapy for nasopharyngeal carcinoma.
Conclusion: This is the first case of postirradiation malignant fibrous histiocytoma of the sphenoid to be reported. Of about 3000 patients treated with radiotherapy for nasopharyngeal carcinoma over a 10-year period in Singapore, only 1 patient developed postirradiation tumour of the sphenoid bone.
Key words: Malignant fibrous histiocytoma, Nasopharyngeal carcinoma, Secondary tumours
Collapse
Affiliation(s)
- Wan-Yee Teo
- Kandang Kerbau Women’s and Children’s Hospital, Singapore
| | - Henry KK Tan
- Kandang Kerbau Women’s and Children’s Hospital, Singapore
| | | | | |
Collapse
|
11
|
Watanabe T, Fuse T, Umezu M, Yamamoto M, Demura K, Niwa Y. Radiation-Induced Osteosarcoma 16 Years After Surgery and Radiation for Glioma-Case Report-. Neurol Med Chir (Tokyo) 2006; 46:51-4. [PMID: 16434828 DOI: 10.2176/nmc.46.51] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 35-year-old man developed osteosarcoma of the left parietal and occipital bones 16 years after radiotherapy for glioma in the right occipital lobe. Radiotherapy of the primary neoplasm used 50 Gy administered to a localized field through two lateral ports. The secondary neoplasm arose contralateral to the primary lesion but within the irradiated field. The tumor had a multilocular cyst with considerable intracranial extension, and symptoms of elevated intracranial pressure were prominent early in the course. After a short-lived initial remission following surgical intervention and chemotherapy, the patient deteriorated because of tumor recurrence and died 18 months after the diagnosis. Radiation-induced osteosarcoma is a well-known but rare complication of radiotherapy for brain neoplasms with a poor prognosis.
Collapse
Affiliation(s)
- Takayuki Watanabe
- Department of Neurosurgery, National Hospital Organization Shizuoka Medical Center, Japan
| | | | | | | | | | | |
Collapse
|
12
|
Osipov V, Ho KC, Krouwer HG, Meyer G, Shidham VB. Post-radiation dedifferentiation of meningioma into osteosarcoma. BMC Cancer 2002; 2:34. [PMID: 12464160 PMCID: PMC138810 DOI: 10.1186/1471-2407-2-34] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2002] [Accepted: 12/03/2002] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A number of osteoblastic meningiomas, primary osteosarcomas of the meninges, and post-radiation osteosarcomas of the head have been reported. However, postradiation dedifferentiation of meningioma into osteosarcoma has not been reported previously. CASE PRESENTATION In 1987 a caucasian man, then 38 years old, presented with a pituitary macroadenoma. He underwent a subtotal resection of the tumor and did well until 1990 when a recurrent tumor was diagnosed. This was treated with subtotal resection of the tumor, followed by radiation therapy for six weeks to a total of 54 Gy. He was considered "disease-free" for nearly ten years. However, most recently in July 2000, he presented with a visual field deficit due to a second recurrence of his pituitary macroadenoma, now with suprasellar extension. At this time, as an incidental finding, a mass attached to the dura was noted in the left parietal hemisphere. This dura-based mass had grown rapidly by January 2001 and was excised. It showed histological, immunohistochemical, and electron microscopic features of malignant meningioma and osteosarcoma with a sharp demarcation between the two components. CONCLUSIONS We report a rare case of a radiation induced dedifferentiation of meningioma into osteosarcoma, which has not been reported previously.
Collapse
Affiliation(s)
- Vladimir Osipov
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Khang-Che Ho
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Glenn Meyer
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Vinod B Shidham
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
13
|
|
14
|
Setzer M, Lang J, Turowski B, Marquardt G. Primary Meningeal Osteosarcoma: Case Report and Review of the Literature. Neurosurgery 2002. [DOI: 10.1227/00006123-200208000-00034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
15
|
Tabone MD, Terrier P, Pacquement H, Brunat-Mentigny M, Schmitt C, Babin-Boilletot A, Mahmoud HH, Kalifa C. Outcome of radiation-related osteosarcoma after treatment of childhood and adolescent cancer: a study of 23 cases. J Clin Oncol 1999; 17:2789-95. [PMID: 10561354 DOI: 10.1200/jco.1999.17.9.2789] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We analyzed the clinical features and outcome of patients with radiation-associated osteosarcoma treated during the era of contemporary chemotherapy. PATIENTS AND METHODS The characteristics and outcome of 23 patients (17 males and six females) treated during childhood or adolescence for a solid tumor who later developed osteosarcomas within the radiation field between 1981 and 1996 were reviewed. RESULTS The median dose of radiation delivered to the first cancer was 47 Gy. Nineteen patients also received chemotherapy. The median time between radiotherapy and the diagnosis of secondary osteosarcoma was 8 years. Histologic slide review showed conventional central osteosarcoma with various differentiation patterns in 21 cases, together with one case of high-grade surface osteosarcoma and one of periosteal osteosarcoma. The sites of involvement were the craniofacial bones in six cases, the first cervical vertebra in one, the girdle bones in seven, and the extremities of long bones in nine. Three patients had metastatic disease at the diagnosis of osteosarcoma. Palliative therapy was administered to seven patients. The aim of treatment was curative for 16 patients, two of whom underwent amputation without further therapy. Intensive chemotherapy regimens were administered to 14 patients before and/or after surgery. Fifteen patients achieved complete surgical remission. Twelve patients were alive and disease-free at a median follow-up duration of 7.5 years. Overall and event-free survivals at 8 years were 50% and 41%, respectively. CONCLUSION Patients with radiation-related osteosarcoma and resectable lesions can be cured with surgery and intensive preoperative and postoperative chemotherapy.
Collapse
Affiliation(s)
- M D Tabone
- French Society of Pediatric Oncology, Paris, France
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Ashkan K, Pollock J, D'Arrigo C, Kitchen ND. Intracranial osteosarcomas: report of four cases and review of the literature. J Neurooncol 1998; 40:87-96. [PMID: 9874190 DOI: 10.1023/a:1006007411312] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Four cases of intracranial osteosarcoma are reported. In three cases the tumors were primary neoplasms arising from the sellar region, base of the occiput and the parieto-occipital area. One case represented osteosarcoma metastatic to the cerebellum, a site not previously described, from a primary tumor at the femur. In addition, the current literature on intracranial osteosarcoma is reviewed.
Collapse
Affiliation(s)
- K Ashkan
- Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, England
| | | | | | | |
Collapse
|