Radiation-induced leiomyosarcoma: does antimetabolite chemotherapy contribute? A report of three cases
Bruce Brockstein1, Arno Mundt, Daniel J Haraf
1Department of Medicine Northwestern University Evanston Northwestern Healthcare 2650 Ridge Ave. Evanston IL 60201 USA.
Purpose:
Radiation therapy in low and high doses is known to be associated with the occurrence of late secondary sarcomas. The addition of chemotherapy has not been clearly demonstrated as a contributing factor. We describe three patients with radiation-associated leiomyosarcoma who had also received antimetabolite chemotherapy.
Methods:
Three cases of leiomyosarcoma occurring 9-27 years after radiation and antimetabolite chemotherapy are presented, along with histopathological details. A Medline search was used to assess prior reports of leiomyosarcoma after radiation.
Results:
These three cases appear to be the first reported in which leiomyosarcoma followed therapy with radiation and antimetabolites.
Discussion:
With the increasing use of antimetabolite therapy combined with radiation, there is the potential for more occurrences of leiomyosarcoma or other post-treatment sarcomas.