Zhang AY, Judson I, Benson C, Wunder JS, Ray-Coquard I, Grimer RJ, Quek R, Wong E, Miah AB, Ferguson PC, Dufresne A, Teh JYH, Stockler M, Tattersall MHN. Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study.
Br J Cancer 2017;
117:326-31. [PMID:
28654633 DOI:
10.1038/bjc.2017.198]
[Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/15/2017] [Accepted: 06/05/2017] [Indexed: 12/23/2022] Open
Abstract
Background:
An increasing number and proportion of cancer patients with apparently localised disease are treated with chemotherapy and radiation therapy in contemporary oncology practice. In a pilot study of radiation-induced sarcoma (RIS) patients, we demonstrated that chemotherapy was associated with a reduced time to development of RIS. We now present a multi-centre collaborative study to validate this association.
Methods:
This was a retrospective cohort study of RIS cases across five large international sarcoma centres between 1 January 2000 to 31 December 2014. The primary endpoint was time to development of RIS.
Results:
We identified 419 patients with RIS. Chemotherapy for the first malignancy was associated with a shorter time to RIS development (HR 1.37; 95% CI: 1.08–1.72; P=0.009). In the multi-variable model, older age (HR 2.11; 95% CI 1.83–2.43; P<0.001) and chemotherapy for the first malignancy (HR 1.61; 95% CI 1.26–2.05; P<0·001) were independently associated with a shorter time to RIS. Anthracyclines and alkylating agents significantly contribute to the effect.
Conclusions:
This study confirms an association between chemotherapy given for the first malignancy and a shorter time to development of RIS.
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