Post-radiation sarcomas. Clinical outcome of 52 Patients

Previous studies reported on post-radiation sarcomas. However, the incidence, latency from radiation therapy, treatment, and survival has been difficult to evaluate. We performed a retrospective, single-institutional study to determine these factors for post-radiation sarcomas.

We retrospectively studied 52 patients with post-radiation sarcomas diagnosed and treated from 1985 to 2011. The mean age was 49 years; 45 patients had bone and 7 soft tissue sarcoma. The mean follow-up was 45 months. Survival was analyzed with respect to age at diagnosis, type (bone vs. soft tissue), histology, location (trunk vs. extremities), size, and surgical treatment (resection vs. amputation).

The risk of post-radiation sarcoma was 0.06% at a mean latency of 15 years (3-50 years) after radiation therapy. The most common histology was osteosarcoma followed by malignant fibrous histiocytoma and fibrosarcoma; all sarcomas were high grade. Survival of the patients with post-radiation sarcomas was 85% at 1 year, 51% at 2 years, 48% at 3 years, and 45% at 5 years. Univariate predictor of survival was only the type of the sarcoma. No variable was significant in multivariate analysis.

Prognosis of post-radiation sarcomas is poor; the type of the sarcomas is the only significant variable for survival.