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Verdin V, Mattart L, Cusumano PG, De Hertogh O, De Meester C, Francart D, Kirova YM, Nelissen X, Sacino F, Vanderick J, Weerts J, Markiewicz S. Angiosarcoma associated with radiation therapy after treatment of breast cancer. Retrospective study on ten years. Cancer Radiother 2021; 25:114-118. [PMID: 33487559 DOI: 10.1016/j.canrad.2020.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The breast sarcoma induced by radiation therapy is rare but increasing, given the increased long-term survival of patients receiving radiation therapy. Fibrosarcoma, histiocytofibroma and angiosarcoma are the most common breast sarcoma. Angiosarcoma is the most common after breast cancer treated by radiation therapy, often diagnosed too late, with a severe prognosis and a high rate of recurrence. However, because of the low incidence of angiosarcoma associated with radiation therapy (AAR), the benefit of radiation therapy in breast cancer treatment outweighs the risk to develop angiosarcoma. The aim of this study is to evaluate these rare cases of AAR diagnosed in eastern Belgium in comparison to the data from the literature. PATIENTS AND METHODS Nine cases of AAR after radiation for breast ductal carcinoma were included in this retrospective study. AAR was diagnosed according to Cahan criteria between January 2007 and December 2016. Latency, incidence, management and prognosis are comparable to the literature. RESULTS, CONCLUSION The median latency was 10 (4-24) years, the incidence of AAR in the East Belgian area was 0.09% of the patients irradiated on the same period. Patients were treated by surgery with wide local excision with or without reconstructive surgery, without radiotherapy and chemotherapy treatment. Kaplan-Meier analysis showed median overall survival of 61.8 months, patient survival of 55.6% at one year and 29.6% at five years. With the constant progress of medicine and its technologies, it would be possible to limit the occurrence of AAR or to diagnose it at an earlier stage.
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Affiliation(s)
- V Verdin
- Department of Abdominal Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - L Mattart
- Department of Abdominal Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - P G Cusumano
- Department of Obstetric Gynaecology, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - O De Hertogh
- Department of Radiation Oncology, Verviers Regional Hospital Center, Rue du Parc, 29, 4800 Verviers, Belgium.
| | - C De Meester
- Department of Abdominal Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - D Francart
- Department of Abdominal Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - Y M Kirova
- Department of Radiation Oncology, Institut Curie, Rue d'Ulm, 26, 75005 Paris, France.
| | - X Nelissen
- Department of Plastic and Reconstructive Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - F Sacino
- Department of Radiation Oncology, University of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium.
| | - J Vanderick
- Department of Radiation Oncology, University of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium.
| | - J Weerts
- Department of Abdominal Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
| | - S Markiewicz
- Department of Abdominal Surgery, CHC Groupe Santé, boulevard Patience et Beaujonc, 2, 4000 Liège, Belgium.
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Torigoe T, Imanishi J, Yazawa Y, Kadono Y, Oda H. The impact of antecedent primary malignancy in soft tissue sarcoma patients. J Orthop Surg (Hong Kong) 2020; 27:2309499019838124. [PMID: 30909802 DOI: 10.1177/2309499019838124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is unclear whether antecedent primary malignancies (APMs) have any negative impact on the prognosis of soft tissue sarcoma (STS). We retrospectively reviewed STS patients with APMs (STS-APM) and compared their survival to those of STS only (STS-O). METHODS Twenty-one cases of STS-APM from 2008 to 2017 in our institution were analyzed. One hundred and seventy cases of STS-O at the same period were compared as a control group. Overall survival was estimated using Kaplan-Meier survival curves and prognostic factors were analyzed using logistic regression analyses and contingency table analyses. RESULTS As the final status of STS-APM patients, 12 patients were in disease-free survival, 5 were alive with disease, 3 have died of disease, and 1 has died of another disease. There was no case that died of APM. The 5-year overall survival rates were 88% in STS-APM and 78% in STS-O, showing no statistical significant ( p = 0.65). The 5-year overall survival rates in each stage of STS-APM and STS-O were 100/100% in stage I, 100/85% in stage II, 86/72% in stage III, and the 3-year overall survival rates were 67/51% in stage IV, with no statistical significance. With regard to prognostic factor, histological grade of STS was the only significant factor. Although antecedent radiotherapy tended to show a high odds ratio, the association was not statistically significant. Antecedent chemotherapy did not show any estimated prognostic risk. CONCLUSIONS Our study suggested that APM in STS patient would not be a negative prognostic factor.
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Affiliation(s)
- Tomoaki Torigoe
- 1 Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Jungo Imanishi
- 1 Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuo Yazawa
- 1 Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yuho Kadono
- 2 Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
| | - Hiromi Oda
- 2 Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
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Liao LQ, Yan HH, Mai JH, Liu WW, Li H, Guo ZM, Zeng ZY, Liu XK. Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma. CHINESE JOURNAL OF CANCER 2016; 35:89. [PMID: 27729091 PMCID: PMC5059957 DOI: 10.1186/s40880-016-0153-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 09/27/2016] [Indexed: 12/30/2022]
Abstract
Background The increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible (RIOSM) has become a significant problem that can limit long-term survival. The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC). Methods We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded. Results For all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty-nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who underwent resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1-, 2-, and 3-year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treatment type. Conclusions RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.
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Affiliation(s)
- Lie-Qiang Liao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Hong-Hong Yan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Jun-Hao Mai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Wei-Wei Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Hao Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Zhu-Ming Guo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Zong-Yuan Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China
| | - Xue-Kui Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China. .,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China.
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Zhang P, Zhao L, Zhu YJ, Qiu B, Guo SP, Li Y, Liu Q, Liu MZ, Xi M. Prognosis of Fibrosarcoma in Patients With and Without a History of Radiation for Nasopharyngeal Carcinoma. Ann Surg Oncol 2016; 24:434-440. [PMID: 27654106 DOI: 10.1245/s10434-016-5589-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine whether radiation-induced fibrosarcoma (RIF) in patients with a history of radiotherapy for nasopharyngeal carcinoma (NPC) was associated with an inferior prognosis compared to sporadic fibrosarcoma of the head and neck. METHODS Forty-two patients with RIF who previously received radiotherapy for NPC and 124 patients with sporadic fibrosarcoma of the head and neck were identified between January 1965 and December 2013 at our institution. Information on clinicopathologic characteristics and treatment was abstracted from medical records. The primary end point was disease-specific survival (DSS). RESULTS The median latency from NPC diagnosis to RIF diagnosis was 9.9 years (range 3.1-36.8 years). RIF was diagnosed at an older age than sporadic fibrosarcoma. Treatment modality was significantly different between the two groups, with only 64.3 % of the RIF group receiving surgery ± adjuvant treatment versus 91.1 % in the sporadic fibrosarcoma group (P < 0.001). Patients with RIF had poorer 5-year DSS compared to the sporadic fibrosarcoma group (36.2 vs. 50.4 %; P = 0.026). Multivariate analysis of the combined group indicated that patient group (P = 0.032), tumor, node, metastasis classification system stage (P = 0.019), histologic grade (P = 0.046) and treatment modality (P < 0.001) were independent variables affecting DSS. CONCLUSIONS Compared to patients with sporadic fibrosarcoma, NPC survivors who develop RIF are older at diagnosis of fibrosarcoma and have an inferior prognosis.
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Affiliation(s)
- Peng Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lei Zhao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yu-Jia Zhu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Bo Qiu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Su-Ping Guo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Pathology, Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Qing Liu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng-Zhong Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Mian Xi
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
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Bjerkehagen B, Småstuen MC, Hall KS, Skjeldal S, Smeland S, Fosså SD. Why do patients with radiation-induced sarcomas have a poor sarcoma-related survival? Br J Cancer 2011; 106:297-306. [PMID: 22173669 PMCID: PMC3261679 DOI: 10.1038/bjc.2011.559] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study aims to provide reasons for the poor sarcoma-related survival in patients with radiation-induced sarcoma (RIS). METHODS We performed a case-control study comparing sarcoma-related survival of 98 patients with RIS to that of 239 sporadic high-grade malignant sarcomas. RESULTS The cumulative sarcoma-related 5-year survival was 32% (95% confidence interval (CI): 22-42) for patients with RIS vs 51% (95% CI: 44-58) for controls (P<0.001). Female gender, central tumour site and incomplete surgical remission were significantly more frequent among RIS patients than in controls. In multivariate analysis incomplete surgical remission (hazard ratio (HR) 4.48, 95% CI: 3.08-6.52), metastases at presentation (HR 2.93, 95% CI: 1.95-4.41), microscopic tumour necrosis (HR 1.88, 95% CI: 1.27-2.78) and central tumour site (HR 1.71, 95% CI: 1.18-2.47) remained significant adverse prognostic factors, but not sarcoma category (RIS vs sporadic). CONCLUSION The poor prognosis of RIS patients are not due to the previous radiotherapy per se, but related to the unfavourable factors - central tumour site, incomplete surgical remission, microscopic tumour necrosis and the presence of metastases, the two former factors overrepresented in RIS.
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Affiliation(s)
- B Bjerkehagen
- Department of Pathology, Postboks 4953, NO-0424 Oslo, Norway.
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Mourad WF, Packianathan S, Shourbaji RA, Russell G, Khan MA, Vijayakumar S. Radiation-induced sarcoma following radiation prophylaxis of heterotopic ossification. Pract Radiat Oncol 2011; 2:151-4. [PMID: 24674090 DOI: 10.1016/j.prro.2011.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 05/24/2011] [Accepted: 06/01/2011] [Indexed: 10/18/2022]
Affiliation(s)
- Waleed F Mourad
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi; Department of Radiation Oncology, Beth Israel Medical Center, New York, New York.
| | - S Packianathan
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Rania A Shourbaji
- Department of Epidemiology and Biostatistics, Jackson State University, Jackson, Mississippi
| | - George Russell
- Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, Mississippi
| | - Majid A Khan
- Department of Radiology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
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Radiation-induced olfactory neuroblastoma: a new etiology is possible. Oral Maxillofac Surg 2010; 15:71-7. [PMID: 20512390 DOI: 10.1007/s10006-010-0234-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Accepted: 05/17/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE Radiation-induced olfactory neuroblastoma (ONB) is an uncommon neoplasm that is generally associated with a poor prognosis. We describe a new case of olfactory neuroblastoma in a patient previously treated for astrocytoma with holocranial radiotherapy 9 years ago. MATERIALS AND METHODS We reviewed the medical records of four patients with radiation-induced olfactory neuroblastoma between 2001 and 2009. RESULTS This work supports the idea that ONB can be induced by radiation. CONCLUSIONS As radiotherapy is a standard treatment in other tumors, clinicians must be aware of the possibility of a second tumor induced by radiation.
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Postirradiation osteosarcoma of the maxilla: a case report and current review of literature. JOURNAL OF ONCOLOGY 2009; 2009:876138. [PMID: 19478960 PMCID: PMC2685995 DOI: 10.1155/2009/876138] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Revised: 10/30/2008] [Accepted: 03/16/2009] [Indexed: 11/17/2022]
Abstract
Background. Radiation-induced sarcomas are well-known potential late sequelae of radiation therapy. They are of rare occurrence in jaw bones and are even rarer in the maxilla. Case report. We report a case of radiation-induced osteosarcoma involving the maxilla in a patient treated with radiotherapy for nasopharyngeal carcinoma 14 years ago. Despite neoadjuvant chemotherapy, surgical treatment could not be performed, and the patient received palliative chemotherapy. Conclusions. Radiation-induced osteosarcomas are aggressive and often elude early detection and timely intervention, rapidly leading to early demise of afflicted patients. Long-term patient follow-up and a high index of suspicion are crucial for timely intervention.
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