Antoine Italiano1, Solène Bringer2, Jean-Yves Blay3, Sylvie Bonvalot4, Axel Le Cesne5, Francois Le Loarer6, Phillipe Maingon7. 1. Department of Medical Oncology, Institut Bergonié, Bordeaux, France; University of Bordeaux, Faculty of Médicine, Bordeaux, France. Electronic address: a.italiano@bordeaux.unicancer.fr. 2. University of Bordeaux, Faculty of Médicine, Bordeaux, France; Department of Radiotherapy, Institut Bergonié, Bordeaux, France. 3. Department of Medical Oncology, Centre Léon Berard, Lyon, France. 4. Department of Surgery, Institut Curie, Paris, France. 5. Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France. 6. Department of Pathology, Institut Bergonié, Bordeaux, France. 7. Department of Radiation Oncology, Sorbonne University, HU La Pitié Salpêtrière Charles Foix, Assistance-Publique des Hôpitaux de Paris, Paris, France.
Abstract
PURPOSE: Radiation therapy is used as a radical treatment for many cancers and is delivered in the neoadjuvant or adjuvant setting, frequently combined with other treatment modalities such as chemotherapy and surgery. However, radiation exposure is a well established risk factor for developing secondary malignancies. Soft-tissue sarcomas are the most common types of radiation-induced tumors in the general population. METHODS: We have analyzed 510 patients from the French Sarcoma Group database. Prognostic factors for locoregional-free Survival (LRFS), metastases-free survival (MFS), and overall Survival (OS) were identified by univariate and multivariate analyses using a Cox regression model. RESULTS: Median overall survival for patients M0 with R0/R1 surgery was 65.1 months (95% CI, 50.0-98.4). The 5-year and 10-year OS rates were 52.9% (47.1-58.2) and 41.0% (34.2-47.7), respectively. On multivariate analysis, the predictors of worse OS were age, R1 margin status, grade 3 and size >55 mm. CONCLUSIONS: We report here the largest series of patients with radiation-induced soft-tissue sarcomas. We demonstrate that a majority of patients can be cured provided they are managed with adequate surgery.
PURPOSE: Radiation therapy is used as a radical treatment for many cancers and is delivered in the neoadjuvant or adjuvant setting, frequently combined with other treatment modalities such as chemotherapy and surgery. However, radiation exposure is a well established risk factor for developing secondary malignancies. Soft-tissue sarcomas are the most common types of radiation-induced tumors in the general population. METHODS: We have analyzed 510 patients from the French Sarcoma Group database. Prognostic factors for locoregional-free Survival (LRFS), metastases-free survival (MFS), and overall Survival (OS) were identified by univariate and multivariate analyses using a Cox regression model. RESULTS: Median overall survival for patients M0 with R0/R1 surgery was 65.1 months (95% CI, 50.0-98.4). The 5-year and 10-year OS rates were 52.9% (47.1-58.2) and 41.0% (34.2-47.7), respectively. On multivariate analysis, the predictors of worse OS were age, R1 margin status, grade 3 and size >55 mm. CONCLUSIONS: We report here the largest series of patients with radiation-induced soft-tissue sarcomas. We demonstrate that a majority of patients can be cured provided they are managed with adequate surgery.