Postradiation sarcomas: 20 cases and a literature review
Identifieur interne : 000977 ( Istex/Corpus ); précédent : 000976; suivant : 000978Postradiation sarcomas: 20 cases and a literature review
Auteurs : Elizabeth M. Murray ; Dudley Werner ; Elizabeth A. Greeff ; Deryck A. TaylorSource :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 1999.
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Abstract
Purpose: To analyze 20 cases of postradiation sarcoma (PRS) to determine dose levels at which this condition developed, the pathology of the initial and postradiation tumors, latency period, and outcome; and to review the literature and propose modified criteria for diagnosis. Methods and Materials: Patient records were reviewed. Previous radiation fields and isodose charts were reconstructed to determine the dose received in the tissue in which the PRS subsequently developed. Results: There were 16 female patients and 4 male patients. Mean age at the time of initial radiotherapy was 28 years. Mean latency was 14 years, with no difference in latency between the adult and pediatric group (t = 0.45, p = 0.37), but shorter latency in the retinoblastoma than in the nonretinoblastoma patients (t = 3.18, p = 0.003). The outcome was poor; 2 patients were alive and disease-free at 2 and 5 years. The 18 patients who died as a result of PRS had a median survival of 1 year. Conclusion: PRSs are rare. Unnecessary radiation must be avoided. Cases should be reported with full details so that risk factors can be ascertained. PRSs usually arise in moderate to higher dose areas. Diagnostic criteria should allow soft tissue tumors and short latency.
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DOI: 10.1016/S0360-3016(99)00279-5
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Tel: +27-21-404-4267; Fax: +27-21-448-5707</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: emurray@ray.uct.ac.za</mods:affiliation></affiliation></author><author><name sortKey="Werner, Dudley" sort="Werner, Dudley" uniqKey="Werner D" first="Dudley" last="Werner">Dudley Werner</name><affiliation><mods:affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation></author><author><name sortKey="Greeff, Elizabeth A" sort="Greeff, Elizabeth A" uniqKey="Greeff E" first="Elizabeth A" last="Greeff">Elizabeth A. Greeff</name><affiliation><mods:affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation></author><author><name sortKey="Taylor, Deryck A" sort="Taylor, Deryck A" uniqKey="Taylor D" first="Deryck A" last="Taylor">Deryck A. Taylor</name><affiliation><mods:affiliation>Department of Anatomical Pathology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29</idno><date when="1999" year="1999">1999</date><idno type="doi">10.1016/S0360-3016(99)00279-5</idno><idno type="url">https://api.istex.fr/document/14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000977</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000977</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Postradiation sarcomas: 20 cases and a literature review</title><author><name sortKey="Murray, Elizabeth M" sort="Murray, Elizabeth M" uniqKey="Murray E" first="Elizabeth M" last="Murray">Elizabeth M. Murray</name><affiliation><mods:affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>Reprint requests to: E. M. Murray, Radiation Oncology, Groote Schuur Hospital, Observatory 7925, South Africa. Tel: +27-21-404-4267; Fax: +27-21-448-5707</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: emurray@ray.uct.ac.za</mods:affiliation></affiliation></author><author><name sortKey="Werner, Dudley" sort="Werner, Dudley" uniqKey="Werner D" first="Dudley" last="Werner">Dudley Werner</name><affiliation><mods:affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation></author><author><name sortKey="Greeff, Elizabeth A" sort="Greeff, Elizabeth A" uniqKey="Greeff E" first="Elizabeth A" last="Greeff">Elizabeth A. Greeff</name><affiliation><mods:affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation></author><author><name sortKey="Taylor, Deryck A" sort="Taylor, Deryck A" uniqKey="Taylor D" first="Deryck A" last="Taylor">Deryck A. Taylor</name><affiliation><mods:affiliation>Department of Anatomical Pathology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="ISSN">0360-3016</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">45</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="951">951</biblScope><biblScope unit="page" to="961">961</biblScope></imprint><idno type="ISSN">0360-3016</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Giant cell tumors</term><term>Postradiation sarcomas</term><term>Radiation complications</term><term>Radiation therapy</term><term>Radiation-induced human sarcomas</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: To analyze 20 cases of postradiation sarcoma (PRS) to determine dose levels at which this condition developed, the pathology of the initial and postradiation tumors, latency period, and outcome; and to review the literature and propose modified criteria for diagnosis. Methods and Materials: Patient records were reviewed. Previous radiation fields and isodose charts were reconstructed to determine the dose received in the tissue in which the PRS subsequently developed. Results: There were 16 female patients and 4 male patients. Mean age at the time of initial radiotherapy was 28 years. Mean latency was 14 years, with no difference in latency between the adult and pediatric group (t = 0.45, p = 0.37), but shorter latency in the retinoblastoma than in the nonretinoblastoma patients (t = 3.18, p = 0.003). The outcome was poor; 2 patients were alive and disease-free at 2 and 5 years. The 18 patients who died as a result of PRS had a median survival of 1 year. Conclusion: PRSs are rare. Unnecessary radiation must be avoided. Cases should be reported with full details so that risk factors can be ascertained. PRSs usually arise in moderate to higher dose areas. Diagnostic criteria should allow soft tissue tumors and short latency.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>sarcoma</json:string><json:string>postradiation</json:string><json:string>radiotherapy</json:string><json:string>latency</json:string><json:string>surg</json:string><json:string>oncol</json:string><json:string>retinoblastoma</json:string><json:string>eld</json:string><json:string>malignant</json:string><json:string>postirradiation</json:string><json:string>oncology</json:string><json:string>breast cancer</json:string><json:string>neoplasm</json:string><json:string>radiat</json:string><json:string>uterus</json:string><json:string>giant cell tumors</json:string><json:string>postradiation sarcomas</json:string><json:string>phys</json:string><json:string>biol</json:string><json:string>cervix</json:string><json:string>dos</json:string><json:string>mmmt</json:string><json:string>megavoltage</json:string><json:string>prss</json:string><json:string>chemotherapy</json:string><json:string>isodose</json:string><json:string>osteosarcoma</json:string><json:string>soft tissue</json:string><json:string>postradiation sarcoma</json:string><json:string>radiat oncol biol phys</json:string><json:string>brosarcoma</json:string><json:string>retinoblastoma patients</json:string><json:string>surg oncol</json:string><json:string>postradiation tumor</json:string><json:string>dose levels</json:string><json:string>postradiation tumors</json:string><json:string>radiation therapy</json:string><json:string>malignancy</json:string><json:string>secondary tumor</json:string><json:string>soft uterus</json:string><json:string>bone sarcomas</json:string><json:string>higher doses</json:string><json:string>carcinoma</json:string><json:string>isodose charts</json:string><json:string>case report</json:string><json:string>cape town</json:string><json:string>postirradiation sarcoma</json:string><json:string>initial tumor</json:string><json:string>area tumor</json:string><json:string>maximum dose point</json:string><json:string>center entrance</json:string><json:string>nonretinoblastoma patients</json:string><json:string>external beam</json:string><json:string>second tumors</json:string><json:string>latency period</json:string><json:string>radiation treatment</json:string><json:string>higher dose areas</json:string><json:string>brous histiocytoma</json:string><json:string>radiation oncology</json:string><json:string>megavoltage radiotherapy</json:string><json:string>dose range</json:string><json:string>clin oncol</json:string><json:string>mullerian tumors</json:string><json:string>soft tissue sarcomas</json:string><json:string>tumor</json:string></teeft></keywords><author><json:item><name>Elizabeth M Murray</name><affiliations><json:string>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</json:string><json:string>Reprint requests to: E. M. Murray, Radiation Oncology, Groote Schuur Hospital, Observatory 7925, South Africa. Tel: +27-21-404-4267; Fax: +27-21-448-5707</json:string><json:string>E-mail: emurray@ray.uct.ac.za</json:string></affiliations></json:item><json:item><name>Dudley Werner</name><affiliations><json:string>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</json:string></affiliations></json:item><json:item><name>Elizabeth A Greeff</name><affiliations><json:string>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</json:string></affiliations></json:item><json:item><name>Deryck A Taylor Ph.D.</name><affiliations><json:string>Department of Anatomical Pathology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Sarcoma</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Postradiation sarcomas</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiation complications</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiation-induced human sarcomas</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiation therapy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Giant cell tumors</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Purpose: To analyze 20 cases of postradiation sarcoma (PRS) to determine dose levels at which this condition developed, the pathology of the initial and postradiation tumors, latency period, and outcome; and to review the literature and propose modified criteria for diagnosis. Methods and Materials: Patient records were reviewed. Previous radiation fields and isodose charts were reconstructed to determine the dose received in the tissue in which the PRS subsequently developed. Results: There were 16 female patients and 4 male patients. Mean age at the time of initial radiotherapy was 28 years. Mean latency was 14 years, with no difference in latency between the adult and pediatric group (t = 0.45, p = 0.37), but shorter latency in the retinoblastoma than in the nonretinoblastoma patients (t = 3.18, p = 0.003). The outcome was poor; 2 patients were alive and disease-free at 2 and 5 years. The 18 patients who died as a result of PRS had a median survival of 1 year. Conclusion: PRSs are rare. Unnecessary radiation must be avoided. Cases should be reported with full details so that risk factors can be ascertained. PRSs usually arise in moderate to higher dose areas. Diagnostic criteria should allow soft tissue tumors and short latency.</abstract><qualityIndicators><score>7.448</score><pdfVersion>1.2</pdfVersion><pdfPageSize>586 x 785 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1251</abstractCharCount><pdfWordCount>6640</pdfWordCount><pdfCharCount>39933</pdfCharCount><pdfPageCount>11</pdfPageCount><abstractWordCount>204</abstractWordCount></qualityIndicators><title>Postradiation sarcomas: 20 cases and a literature review</title><pii><json:string>S0360-3016(99)00279-5</json:string></pii><genre><json:string>research-article</json:string></genre><host><title>International Journal of Radiation Oncology, Biology, Physics</title><language><json:string>unknown</json:string></language><publicationDate>1999</publicationDate><issn><json:string>0360-3016</json:string></issn><pii><json:string>S0360-3016(00)X0069-7</json:string></pii><volume>45</volume><issue>4</issue><pages><first>951</first><last>961</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>radiology, nuclear medicine & medical imaging</json:string><json:string>oncology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>1999</publicationDate><copyrightDate>1999</copyrightDate><doi><json:string>10.1016/S0360-3016(99)00279-5</json:string></doi><id>14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Postradiation sarcomas: 20 cases and a literature review</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©1999 Elsevier Science Inc.</p></availability><date>1999</date></publicationStmt><notesStmt><note type="content">Section title: Clinical Investigations</note><note type="content">Fig. 1: Case 6. (a) One anterior and posterior field, and two radium insertions; secondary tumor in anterior field. (b) Total gray distribution 1 cm inferior to central axis. Level through secondary tumor. (c) CT scan showing postradiation tumor abdominal wall. Shaded area = tumor, ♢ = maximum dose point, × = field center entrance.</note><note type="content">Fig. 2: Case 13. (a) Five planned fields. Secondary tumor in relation to left fields. (b) Total gray distribution central axis level through mid-secondary tumor. (c) CT scan showing postradiation tumor of the orbit. Shaded area = tumor, ♢ = maximum dose point, × = field center entrance.</note><note type="content">Fig. 3: Case 18. (a) Right and left lateral fields, two courses. Secondary tumor in relation to fields. (b) Total gray distribution 7.5 cm inferior to central axis. Level through main tumor mass. (c) Plain radiograph showing postradiation osteosarcoma. Shaded area = tumor, ♢ = maximum dose point, × = field center entrance.</note><note type="content">Fig. 4: Histogram showing dose levels at which PRS occurred with three-point moving average graph superimposed.</note><note type="content">Table 1: Postradiation sarcomas: 20 cases from the University of Cape Town, South Africalegend legend legend legend legend legend</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Postradiation sarcomas: 20 cases and a literature review</title><author xml:id="author-0000"><persName><forename type="first">Elizabeth M</forename><surname>Murray</surname></persName><email>emurray@ray.uct.ac.za</email><note type="biography">M.Med.</note><affiliation>M.Med.</affiliation><affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation><affiliation>Reprint requests to: E. M. Murray, Radiation Oncology, Groote Schuur Hospital, Observatory 7925, South Africa. Tel: +27-21-404-4267; Fax: +27-21-448-5707</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Dudley</forename><surname>Werner</surname></persName><note type="biography">F.R.C.R.</note><affiliation>F.R.C.R.</affiliation><affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Elizabeth A</forename><surname>Greeff</surname></persName><note type="biography">H.D.Rad(T)</note><affiliation>H.D.Rad(T)</affiliation><affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Deryck A</forename><surname>Taylor</surname></persName><roleName type="degree">Ph.D.</roleName><affiliation>Department of Anatomical Pathology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation></author><idno type="istex">14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29</idno><idno type="DOI">10.1016/S0360-3016(99)00279-5</idno><idno type="PII">S0360-3016(99)00279-5</idno></analytic><monogr><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="pISSN">0360-3016</idno><idno type="PII">S0360-3016(00)X0069-7</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999"></date><biblScope unit="volume">45</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="951">951</biblScope><biblScope unit="page" to="961">961</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1999</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Purpose: To analyze 20 cases of postradiation sarcoma (PRS) to determine dose levels at which this condition developed, the pathology of the initial and postradiation tumors, latency period, and outcome; and to review the literature and propose modified criteria for diagnosis. Methods and Materials: Patient records were reviewed. Previous radiation fields and isodose charts were reconstructed to determine the dose received in the tissue in which the PRS subsequently developed. Results: There were 16 female patients and 4 male patients. Mean age at the time of initial radiotherapy was 28 years. Mean latency was 14 years, with no difference in latency between the adult and pediatric group (t = 0.45, p = 0.37), but shorter latency in the retinoblastoma than in the nonretinoblastoma patients (t = 3.18, p = 0.003). The outcome was poor; 2 patients were alive and disease-free at 2 and 5 years. The 18 patients who died as a result of PRS had a median survival of 1 year. Conclusion: PRSs are rare. Unnecessary radiation must be avoided. Cases should be reported with full details so that risk factors can be ascertained. PRSs usually arise in moderate to higher dose areas. Diagnostic criteria should allow soft tissue tumors and short latency.</p></abstract><textClass><keywords scheme="keyword"><list><head>article-category</head><item><term>Sarcoma</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Postradiation sarcomas</term></item><item><term>Radiation complications</term></item><item><term>Radiation-induced human sarcomas</term></item><item><term>Radiation therapy</term></item><item><term>Giant cell tumors</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1999">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: ce:floats; body; tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="gr1"></istex:entity><istex:entity SYSTEM="gr2" NDATA="IMAGE" name="gr2"></istex:entity><istex:entity SYSTEM="gr3" NDATA="IMAGE" name="gr3"></istex:entity><istex:entity SYSTEM="gr4" NDATA="IMAGE" name="gr4"></istex:entity></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>ROB</jid><aid>6603</aid><ce:pii>S0360-3016(99)00279-5</ce:pii><ce:doi>10.1016/S0360-3016(99)00279-5</ce:doi><ce:copyright type="full-transfer" year="1999">Elsevier Science Inc.</ce:copyright><ce:doctopics><ce:doctopic><ce:text>Sarcoma</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:dochead><ce:textfn>Clinical Investigations</ce:textfn></ce:dochead><ce:title>Postradiation sarcomas: 20 cases and a literature review</ce:title><ce:presented>Presented in part as a poster at the 13th National Congress of the South African Society of Radiotherapists, South Africa, April 22–26, 1990.</ce:presented><ce:author-group><ce:author><ce:given-name>Elizabeth M</ce:given-name><ce:surname>Murray</ce:surname><ce:roles>M.Med.</ce:roles><ce:cross-ref refid="AFF1">∗</ce:cross-ref><ce:cross-ref refid="CORR1">*</ce:cross-ref><ce:e-address>emurray@ray.uct.ac.za</ce:e-address></ce:author><ce:author><ce:given-name>Dudley</ce:given-name><ce:surname>Werner</ce:surname><ce:roles>F.R.C.R.</ce:roles><ce:cross-ref refid="AFF1">∗</ce:cross-ref></ce:author><ce:author><ce:given-name>Elizabeth A</ce:given-name><ce:surname>Greeff</ce:surname><ce:roles>H.D.Rad(T)</ce:roles><ce:cross-ref refid="AFF1">∗</ce:cross-ref></ce:author><ce:author><ce:given-name>Deryck A</ce:given-name><ce:surname>Taylor</ce:surname><ce:degrees>Ph.D.</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>†</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>∗</ce:label><ce:textfn>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>†</ce:label><ce:textfn>Department of Anatomical Pathology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</ce:textfn></ce:affiliation><ce:correspondence id="CORR1"><ce:label>*</ce:label><ce:text>Reprint requests to: E. M. Murray, Radiation Oncology, Groote Schuur Hospital, Observatory 7925, South Africa. Tel: +27-21-404-4267; Fax: +27-21-448-5707</ce:text></ce:correspondence></ce:author-group><ce:date-accepted day="30" month="6" year="1999"></ce:date-accepted><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Purpose: To analyze 20 cases of postradiation sarcoma (PRS) to determine dose levels at which this condition developed, the pathology of the initial and postradiation tumors, latency period, and outcome; and to review the literature and propose modified criteria for diagnosis.</ce:simple-para><ce:simple-para>Methods and Materials: Patient records were reviewed. Previous radiation fields and isodose charts were reconstructed to determine the dose received in the tissue in which the PRS subsequently developed.</ce:simple-para><ce:simple-para>Results: There were 16 female patients and 4 male patients. Mean age at the time of initial radiotherapy was 28 years. Mean latency was 14 years, with no difference in latency between the adult and pediatric group (<ce:italic>t</ce:italic> = 0.45, <ce:italic>p</ce:italic> = 0.37), but shorter latency in the retinoblastoma than in the nonretinoblastoma patients (<ce:italic>t</ce:italic> = 3.18, <ce:italic>p</ce:italic> = 0.003). The outcome was poor; 2 patients were alive and disease-free at 2 and 5 years. The 18 patients who died as a result of PRS had a median survival of 1 year.</ce:simple-para><ce:simple-para>Conclusion: PRSs are rare. Unnecessary radiation must be avoided. Cases should be reported with full details so that risk factors can be ascertained. PRSs usually arise in moderate to higher dose areas. Diagnostic criteria should allow soft tissue tumors and short latency.</ce:simple-para></ce:abstract-sec></ce:abstract><ce:keywords class="keyword"><ce:section-title>Keywords</ce:section-title><ce:keyword><ce:text>Postradiation sarcomas</ce:text></ce:keyword><ce:keyword><ce:text>Radiation complications</ce:text></ce:keyword><ce:keyword><ce:text>Radiation-induced human sarcomas</ce:text></ce:keyword><ce:keyword><ce:text>Radiation therapy</ce:text></ce:keyword><ce:keyword><ce:text>Giant cell tumors</ce:text></ce:keyword></ce:keywords></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Postradiation sarcomas: 20 cases and a literature review</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Postradiation sarcomas: 20 cases and a literature review</title></titleInfo><name type="personal"><namePart type="given">Elizabeth M</namePart><namePart type="family">Murray</namePart><affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation><affiliation>Reprint requests to: E. M. Murray, Radiation Oncology, Groote Schuur Hospital, Observatory 7925, South Africa. Tel: +27-21-404-4267; Fax: +27-21-448-5707</affiliation><affiliation>E-mail: emurray@ray.uct.ac.za</affiliation><description>M.Med.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dudley</namePart><namePart type="family">Werner</namePart><affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation><description>F.R.C.R.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elizabeth A</namePart><namePart type="family">Greeff</namePart><affiliation>Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation><description>H.D.Rad(T)</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Deryck A</namePart><namePart type="family">Taylor</namePart><namePart type="termsOfAddress">Ph.D.</namePart><affiliation>Department of Anatomical Pathology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1999</dateIssued><copyrightDate encoding="w3cdtf">1999</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Purpose: To analyze 20 cases of postradiation sarcoma (PRS) to determine dose levels at which this condition developed, the pathology of the initial and postradiation tumors, latency period, and outcome; and to review the literature and propose modified criteria for diagnosis. Methods and Materials: Patient records were reviewed. Previous radiation fields and isodose charts were reconstructed to determine the dose received in the tissue in which the PRS subsequently developed. Results: There were 16 female patients and 4 male patients. Mean age at the time of initial radiotherapy was 28 years. Mean latency was 14 years, with no difference in latency between the adult and pediatric group (t = 0.45, p = 0.37), but shorter latency in the retinoblastoma than in the nonretinoblastoma patients (t = 3.18, p = 0.003). The outcome was poor; 2 patients were alive and disease-free at 2 and 5 years. The 18 patients who died as a result of PRS had a median survival of 1 year. Conclusion: PRSs are rare. Unnecessary radiation must be avoided. Cases should be reported with full details so that risk factors can be ascertained. PRSs usually arise in moderate to higher dose areas. Diagnostic criteria should allow soft tissue tumors and short latency.</abstract><note type="content">Section title: Clinical Investigations</note><note type="content">Fig. 1: Case 6. (a) One anterior and posterior field, and two radium insertions; secondary tumor in anterior field. (b) Total gray distribution 1 cm inferior to central axis. Level through secondary tumor. (c) CT scan showing postradiation tumor abdominal wall. Shaded area = tumor, ♢ = maximum dose point, × = field center entrance.</note><note type="content">Fig. 2: Case 13. (a) Five planned fields. Secondary tumor in relation to left fields. (b) Total gray distribution central axis level through mid-secondary tumor. (c) CT scan showing postradiation tumor of the orbit. Shaded area = tumor, ♢ = maximum dose point, × = field center entrance.</note><note type="content">Fig. 3: Case 18. (a) Right and left lateral fields, two courses. Secondary tumor in relation to fields. (b) Total gray distribution 7.5 cm inferior to central axis. Level through main tumor mass. (c) Plain radiograph showing postradiation osteosarcoma. Shaded area = tumor, ♢ = maximum dose point, × = field center entrance.</note><note type="content">Fig. 4: Histogram showing dose levels at which PRS occurred with three-point moving average graph superimposed.</note><note type="content">Table 1: Postradiation sarcomas: 20 cases from the University of Cape Town, South Africalegend legend legend legend legend legend</note><subject><genre>article-category</genre><topic>Sarcoma</topic></subject><subject lang="en"><genre>Keywords</genre><topic>Postradiation sarcomas</topic><topic>Radiation complications</topic><topic>Radiation-induced human sarcomas</topic><topic>Radiation therapy</topic><topic>Giant cell tumors</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Radiation Oncology, Biology, Physics</title></titleInfo><titleInfo type="abbreviated"><title>ROB</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19991101</dateIssued></originInfo><identifier type="ISSN">0360-3016</identifier><identifier type="PII">S0360-3016(00)X0069-7</identifier><part><date>19991101</date><detail type="volume"><number>45</number><caption>vol.</caption></detail><detail type="issue"><number>4</number><caption>no.</caption></detail><extent unit="issue pages"><start>835</start><end>1094</end></extent><extent unit="pages"><start>951</start><end>961</end></extent></part></relatedItem><identifier type="istex">14E4502C3AB78AF8E697B968AE4AFB9AFC5C0B29</identifier><identifier type="DOI">10.1016/S0360-3016(99)00279-5</identifier><identifier type="PII">S0360-3016(99)00279-5</identifier><accessCondition type="use and reproduction" contentType="copyright">©1999 Elsevier Science Inc.</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Elsevier Science Inc., ©1999</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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