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Wong HH, Cojocaru E, Watkins J, James S, Aloysius T, Harrington J, Horan G, Hatcher H. Radiation-induced angiosarcoma of the breast: retrospective analysis at a regional treatment centre. Breast Cancer 2024; 31:272-282. [PMID: 38147173 DOI: 10.1007/s12282-023-01535-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Radiation-induced angiosarcoma (RIA) is an uncommon but morbid complication after radiotherapy for breast cancer. METHODS Retrospective analysis of breast RIA patients at Cambridge University Hospital (CUH), a regional treatment centre in the East of England. RESULTS 22 patients were identified between 2010 and 2022. Median age of diagnosis was 65 years (range 41-78). Median time from breast radiotherapy to RIA diagnosis was 6.5 years (range 2.4-16.0)-this interval has decreased over the last 24 years (r2 = 0.6601). 9% had metastasis at presentation. All patients underwent surgery (55% at CUH, 45% at local hospitals). 27% received peri-operative pegylated liposomal doxorubicin in the first-line setting. 62% relapsed following their primary curative-intent treatments after a median of 28 months. Metastases occurred in 36%, the commonest sites being lung (100%) and lymph node (50%). 2-year and 5-year overall survival (OS) rates for all patients were 73% and 60%, respectively. No correlation between progression-free survival (PFS) and OS was found with tumour size, margin, peri-operative chemotherapy, and whether surgery was performed at CUH. Patients with multifocal disease on their breasts had shorter PFS following surgery compared to single-lesion disease (median 10 vs 65 months; HR = 4.359 [95% CI 1.342-14.16]; P = 0.0143). Patients aged > 72 years had a median OS of 45 months vs 102 months for those ≤ 72 years (HR = 7.129 [95% CI 1.646-30.88]; P = 0.0086). CONCLUSION RIA has high rates of recurrence and mortality and appears to be occurring sooner after breast radiotherapy. Further studies on its pathogenesis and effective treatment are warranted.
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Affiliation(s)
- Han Hsi Wong
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
| | - Elena Cojocaru
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - James Watkins
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Sujil James
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
- School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SP, UK
| | - Tony Aloysius
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
- School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SP, UK
| | - Jennifer Harrington
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Gail Horan
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Helen Hatcher
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
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Babalola IT, Suleiman G. Design, synthesis, and molecular docking studies of N-substituted sulfonamides as potential anticancer therapeutics. J Taibah Univ Med Sci 2024; 19:175-183. [PMID: 38047237 PMCID: PMC10692713 DOI: 10.1016/j.jtumed.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/02/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives The goal of this study was to design and enable development of anticancer sulfonamides by coupling amines and dansyl chloride with strategically selected substituents. The synthesized structures were characterized by NMR and mass spectrometry. In addition, molecular docking analysis was used to determine the binding ability of sulfonamides toward 1AZM, a possible drug target, as compared with that of the well-known drug acetazolamide. Methods Sulfonamides were synthesized by coupling amines and dansyl chloride under highly favorable conditions. The designed sulfonamides incorporated strategically positioned substituents to impart diverse biological properties. The synthesized structures were validated with NMR and mass spectra. Molecular docking analysis was performed to evaluate the binding affinities of the synthesized sulfonamides with the potential drug target 1AZM. Results The synthesis of sulfonamides through the coupling of amines and dansyl chloride was successfully achieved. The validation of the synthesized structures with NMR and mass spectra confirmed their chemical identities. Molecular docking analysis revealed that the synthesized sulfonamides displayed binding affinities ranging from -6.8 to -8.2 kcal/mol toward the potential drug target 1AZM. Importantly, all derivatives exhibited superior binding affinities to acetazolamide (-5.25 kcal/mol). Conclusions The coupling of amines and dansyl chloride enabled efficient, straightforward sulfonamide synthesis. The strategic design of sulfonamides with specific substituents endows diverse biological properties, including potential anti-cancer activity. The elucidation of the synthesized compounds with NMR and mass spectra confirmed their structures. Molecular docking analysis demonstrated that the synthesized sulfonamides exhibited favorable binding affinities toward the potential drug target 1AZM. Notably, all derivatives displayed higher binding affinities, ranging from -6.8 to -8.2 kcal/mol, than the recommended drug acetazolamide (-5.25 kcal/mol), thus suggesting their potential as highly effective analogues for further validation in cancer therapy.
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Dutra MP, Rodrigues CM, Peretz-Soroka H, Ribeiro M, Shultz D, Hodgson D, Tsang DS, Gupta AA. Radiation-induced sarcomas following childhood cancer - A Canadian Sarcoma Research and Clinical Collaboration Study (CanSaRCC). Cancer Rep (Hoboken) 2023:e1834. [PMID: 37178052 DOI: 10.1002/cnr2.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Radiation-induced sarcoma (RIS) is a late toxicity of radiation therapy (RT) usually associated with poor prognosis. Due to ongoing improvements in childhood cancer treatment and patient outcomes, RIS may become more prevalent notwithstanding evolving indications for RT. Due to limited reported studies, we sought to review our experience with RIS in survivors of pediatric cancer. METHODOLOGY Data were collected on RIS patients following treatment for childhood cancer (initial diagnosis <18 years) identified in the CanSaRCC database. Additionally, details on the protocol guidance at time of treatment were compared with current guidelines for the same disease. RESULTS Among 12 RIS identified, median age at initial diagnosis was 3.5 years (range 0.16-14) and the latency from RT to RIS diagnosis was 24.5 (range 5.4-46.2) years. Initial diagnoses included neuroblastoma, rhabdomyosarcoma, Ewing sarcoma, Wilms tumor, retinoblastoma and Hodgkin's Lymphoma. RIS histologies included osteosarcoma and soft tissue sarcomas. In comparison to protocols followed at time of diagnosis to current ones (2022), 7/12 (58%) patients would have required RT. RIS treatment included chemotherapy, radiation and surgery in 3/11 (27%), 10/11 (90%), and 7/11 (63%) patients, respectively. With a median follow-up time of 4.7 years from diagnosis of RIS, 8 (66%) patients were alive and 4 (33%) had died of progressive RIS. CONCLUSION RIS is a serious late effect of radiotherapy in childhood cancer; however, radiation remains an integral component of primary tumor management and requires participation from a specialized multi-disciplinary team, aiming to mitigate RIS and other potential late effects.
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Affiliation(s)
- Marina Parisi Dutra
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Caroline Mary Rodrigues
- Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Hagit Peretz-Soroka
- Canadian Sarcoma Research and Clinical Collaboration, CanSaRCC, Toronto, Ontario, Canada
| | - Mauricio Ribeiro
- Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Shultz
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Hodgson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Derek S Tsang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Abha A Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
- Canadian Sarcoma Research and Clinical Collaboration, CanSaRCC, Toronto, Ontario, Canada
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Zhu S, Wang H, Lin L, Fei X, Wu J. Primary breast osteosarcoma in a patient previously treated for ipsilateral invasive ductal carcinoma: An unusual case report with clinical and genomic features. Front Oncol 2023; 12:1013653. [PMID: 36755863 PMCID: PMC9899908 DOI: 10.3389/fonc.2022.1013653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/12/2022] [Indexed: 01/24/2023] Open
Abstract
Primary breast osteosarcoma is a rare subtype of breast malignancy with limited clinical evidence, inadequate biological understanding, and unmet treatment consensus. Here, we report an unusual case of primary breast osteosarcoma developing in the same quadrant of the breast 2 years after initial dissection and radiation of invasive ductal carcinoma. Thorough evaluations of imaging and pathology were conducted while genomic alterations of both primary and secondary tumors, as well as peripheral blood samples, were explored through the next-generation sequencing technique. A comprehensive review of the current literature was also performed on this rare malignancy.
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Affiliation(s)
- Siji Zhu
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haoyu Wang
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Lin
- Department of Clinical Laboratory, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochun Fei
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Jiayi Wu, ; Xiaochun Fei,
| | - Jiayi Wu
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Jiayi Wu, ; Xiaochun Fei,
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Veiga LHS, Vo JB, Curtis RE, Mille MM, Lee C, Ramin C, Bodelon C, Aiello Bowles EJ, Buist DSM, Weinmann S, Feigelson HS, Gierach GL, Berrington de Gonzalez A. Treatment-related thoracic soft tissue sarcomas in US breast cancer survivors: a retrospective cohort study. Lancet Oncol 2022; 23:1451-1464. [PMID: 36240805 PMCID: PMC9633446 DOI: 10.1016/s1470-2045(22)00561-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Soft tissue sarcoma is a rare but serious side-effect of radiotherapy to treat breast cancer, and rates are increasing in the USA. We evaluated potential co-factors in two complimentary cohorts of US breast cancer survivors. METHODS In this retrospective cohort study, we sourced data from the Kaiser Permanente (KP) cohort and the Surveillance, Epidemiology, and End Results (SEER) 13 registries cohort, both in the USA. The KP cohort included 15 940 women diagnosed with breast cancer from Jan 1, 1990, to Dec 31, 2016, in KP Colorado, KP Northwest (which serves Oregon and Southwest Washington state), or KP Washington, with detailed treatment data and comorbidities (including hypertension and diabetes at or before breast cancer diagnosis) from electronic medical records. The SEER cohort included 457 300 women diagnosed with breast cancer from Jan 1, 1992, to Dec 31, 2016, within the 13 SEER registries across the USA, with initial treatment data (yes vs no or unknown). Eligibility criteria in both cohorts were female breast cancer survivors (stage I-III) aged 20-84 years at diagnosis who had breast cancer surgery, and had survived at least 1 year after breast cancer diagnosis. The outcome of interest was any second thoracic soft tissue sarcoma (angiosarcomas and other subtypes) that developed at least 1 year after breast cancer diagnosis. Risk factors for thoracic soft tissue sarcoma were assessed using multivariable Poisson regression models. FINDINGS In the KP cohort, median follow-up was 9·3 years (IQR 5·7-13·9) and 19 (0·1%) of 15 940 eligible, evaluable women developed a thoracic soft tissue sarcoma (11 angiosarcomas, eight other subtypes). Most (94·7%; 18 of 19) thoracic soft tissue sarcomas occurred in women treated with radiotherapy; thus, radiotherapy was associated with a significantly increased risk of developing a thoracic soft tissue sarcoma (relative risk [RR] 8·1 [95% CI 1·1-60·4]; p=0·0052), but there was no association with prescribed dose, fractionation, or boost. The RR of angiosarcoma after anthracyclines was 3·6 (95% CI 1·0-13·3; p=0·058). Alkylating agents were associated with an increased risk of developing other sarcomas (RR 7·7 [95% CI 1·2-150·8]; p=0·026). History of hypertension (RR 4·8 [95% CI 1·3-17·6]; p=0·017) and diabetes (5·3 [1·4-20·8]; p=0·036) were each associated with around a five-times increased risk of angiosarcoma. In the SEER cohort, 430 (0·1%) of 457 300 patients had subsequent thoracic soft tissue sarcomas (268 angiosarcomas and 162 other subtypes) after a median follow-up of 8·3 years (IQR 4·3-13·9). Most (77·9%; 335 of 430) cases occurred after radiotherapy; thus, radiotherapy was associated with a significantly increased risk of developing a thoracic soft tissue sarcoma (RR 3·0 [95% CI 2·4-3·8]; p<0·0001) and, for angiosarcomas, the RR for breast-conserving surgery plus radiotherapy versus mastectomy plus radiotherapy was 1·9 (1·1-3·3; p=0·012). By 10 years after radiotherapy, the cumulative incidence of thoracic soft tissue sarcoma was 0·21% (95% CI 0·12-0·34) in the KP cohort and 0·15% (95% CI 0·13-0·17) in SEER. INTERPRETATION Radiotherapy was the strongest risk factor for thoracic soft tissue sarcoma in both cohorts. This finding, along with the novel findings for diabetes and hypertension as potential risk factors for angiosarcomas, warrant further investigation as potential targets for prevention strategies and increased surveillance. FUNDING US National Cancer Institute and National Institutes of Health.
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Affiliation(s)
- Lene H S Veiga
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
| | - Jacqueline B Vo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Rochelle E Curtis
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Matthew M Mille
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Cody Ramin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Clara Bodelon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Erin J Aiello Bowles
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Diana S M Buist
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA; Bernard J Tyson Kaiser Permanente School of Medicine, Pasadena, CA, USA
| | - Sheila Weinmann
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Heather Spencer Feigelson
- Bernard J Tyson Kaiser Permanente School of Medicine, Pasadena, CA, USA; Institute for Health Research, Kaiser Permanente, Denver, CO, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Wang WJ, Li M, Pan XB. Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy. J Cancer 2022; 13:3452-3462. [PMID: 36313032 PMCID: PMC9608213 DOI: 10.7150/jca.77768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose: To identify risk factors of secondary cancer in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Materials and methods: The data of NPC patients with secondary cancer were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2016. Univariate and multivariate logistic regression analysis was performed to identify risk factors of secondary cancer. Risk factors selected from the multivariable logistic regression analysis were used to build a predicting model. Results: A total of 3931 patients were included: 329 (8.37%) patients developed secondary cancers and 3602 (91.63%) patients did not have secondary cancers. Univariate logistic regression analysis revealed that age, race, and the American Joint Committee on Cancer (AJCC) stage were risk factors of secondary cancer. Multivariable analysis demonstrated that age [Odds ratio (OR) = 1.03, P < 0.001], race (OR = 1.17, P = 0.010), AJCC stage (OR = 0.82, P = 0.002), and chemotherapy (OR = 1.55, P = 0.028) were independent risk factors of secondary cancer. Age, race, AJCC stage, and chemotherapy were entered into a nomogram for predicting secondary cancer. The area under the ROC curve of the nomogram was 0.645 [95% confidence interval (CI): 0.617-0.673]. The decision curve showed that if the threshold probability is between 4% and 25%, using the nomogram added more benefit than either the treat-all-patients scheme or the treat-none scheme. Conclusion: Age, race, AJCC stage, and chemotherapy were independent risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy.
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Affiliation(s)
- Wen-Jie Wang
- Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Miao Li
- Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Xin-Bin Pan
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530021, P.R. China.,✉ Corresponding author: Xin-Bin Pan. Address: No. 71 Hedi Road, Qingxiu District, Nanning, Guangxi 530021, P.R. China; ; Telephone: [+8613471171468]; Fax: [0771-5312000]
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Laurino S, Omer LC, Albano F, Marino G, Bianculli A, Solazzo AP, Sgambato A, Falco G, Russi S, Bochicchio AM. Radiation-induced sarcomas: A single referral cancer center experience and literature review. Front Oncol 2022; 12:986123. [PMID: 36249019 PMCID: PMC9561616 DOI: 10.3389/fonc.2022.986123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objective The oncogenic effect of ionizing radiation is widely known. Sarcomas developing after radiation therapy (RT), termed “iatrogenic disease of success”, represent a growing problem, since the advancements in cancer management and screening programs have increased the number of long-term cancer survivors. Although many patients have been treated with radiation therapy, only few data are available on radiation-induced sarcomas (RIS). Methods We examined the medical and radiological records of 186 patients with histologically proven soft tissue and bone sarcomas, which referred to IRCCS CROB Centro di Riferimento Oncologico della Basilicata from January 2009 to May 2022. Among them, seven patients received a histological diagnosis of secondary RIS, according to Cahan’s criteria. Clinicopathological features and treatment follow-up data of RIS patients were retrospectively analyzed. Results Among these secondary RIS, five arose in irradiated breast cancer (5/2,570, 0.19%) and two in irradiated head and neck cancer (2/1,986, 0.10%) patients, with a mean onset latency time of 7.3 years. The histology of RIS was one desmoid tumor, two angiosarcomas, one chondrosarcoma, two leiomyosarcomas, and one undifferentiated pleomorphic sarcoma. Out of the seven RIS, one received radiotherapy, one received electrochemotherapy (ECT), one received a second-line chemotherapy, three were subjected to three lines of chemotherapy, and one underwent radiofrequency ablation, chemotherapy, and ECT. Median survival time is 36 months. No significant survival differences were found stratifying patients for age at RT, latency time, and age at RIS diagnosis. Conclusions RIS represents a possible complication for long-survivor cancer patients. Therefore, adherence to a strict follow-up after the radiation treatment is recommended to allow early diagnosis and optimal management of RIS patients. After the planned follow-up period, considering the long-term risk to develop a RIS, a specific multispecialty survivorship care plan could be of benefit for patients.
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Affiliation(s)
- Simona Laurino
- Laboratory of Preclinical and Translational Research, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Ludmila Carmen Omer
- Trial Office, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Francesco Albano
- Laboratory of Preclinical and Translational Research, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Graziella Marino
- Department of Breast Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Antonella Bianculli
- Radiotherapy Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Angela Pia Solazzo
- Radiotherapy Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Alessandro Sgambato
- Laboratory of Preclinical and Translational Research, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Geppino Falco
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Sabino Russi
- Laboratory of Preclinical and Translational Research, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
- *Correspondence: Sabino Russi,
| | - Anna Maria Bochicchio
- Multispecialty Tumor Board, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
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Mirjolet C, Diallo I, Bertaut A, Veres C, Sargos P, Helfre S, Sunyach MP, Truc G, Le Pechoux C, Paumier A, Ducassou A, Jolnerovski M, Thariat J, Lapeyre M, Cordoba A, Mahé MA, Maingon P. Treatment related factors associated with the risk of breast radio-induced-sarcoma. Radiother Oncol 2022; 171:14-21. [DOI: 10.1016/j.radonc.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 03/14/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
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9
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Nakashima H, Takatsu T, Imai R. Radiation-induced osteosarcoma in the pubic bone after proton radiotherapy for prostate cancer: a case report. J Rural Med 2022; 17:94-100. [PMID: 35432636 PMCID: PMC8984621 DOI: 10.2185/jrm.2021-047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/26/2021] [Indexed: 11/27/2022] Open
Abstract
Objective: Radiation-induced sarcoma (RIS), which develops after
radiotherapy, occurs as a secondary sarcoma in the irradiated area after a long latency
period following radiation exposure. Patient: A 59-year-old man underwent hormone therapy for prostate cancer,
followed by proton therapy (74 GyE) four years ago. Positron emission tomography/computed
tomography performed 2.5 years later revealed 18F-FDG accumulation in the left
pubis. Three years after proton therapy, the patient developed gradually worsening left
inguinal pain and visited our department. Imaging revealed bone destruction with a mixture
of osteolysis and osteogenesis in the left pubis and the presence of an extraosseous
tumor. Following biopsy, the patient was diagnosed with osteosarcoma. Results: A systemic investigation revealed lung metastasis, and chemotherapy
was initiated. The lung metastases shrank, and carbon ion radiotherapy (CIRT, 70.4 GyE)
was performed on the left pubic lesion after colostomy. Six months after carbon ion
radiotherapy, recurrence was observed in the irradiated field, and CIRT was performed
again. However, the patient died 22 months after the initial diagnosis because of
cancerous pleurisy and pericarditis. Conclusions: Although RIS is rare, it should be actively identified using
biopsy to confirm the diagnosis, keeping in mind that it is an important late complication
of radiotherapy.
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Affiliation(s)
- Hiroatsu Nakashima
- Department of Orthopedic Surgery, Gifu Prefectural Tajimi Hospital, Japan
| | - Tetsuro Takatsu
- Department of Orthopedic Surgery, Gifu Prefectural Tajimi Hospital, Japan
| | - Reiko Imai
- Division of Radiation Oncology, QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Japan
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Smith JB, Cass LM, Simpson MC, Osazuwa-Peters N, Ward GM, Massa ST. Radiation-Associated Sarcoma of the Head and Neck: Incidence, Latency, and Survival. Laryngoscope 2021; 132:1034-1041. [PMID: 34779517 DOI: 10.1002/lary.29942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Radiation-associated sarcomas of the head and neck (RASHN) are known but rare sequelae after radiation for squamous cell carcinoma. The purpose of this study was to characterize RASHN, estimate the risk of RASHN in head and neck squamous cell patients after therapeutic radiation, and compare their survival to that of patients with de novo sarcomas of the head and neck (dnSHN). STUDY DESIGN Retrospective database analysis. METHODS RASHN and dnSHN cases were collected from the Surveillance, Epidemiology, and End Results Database to identify risk factors and calculate incidence and latency. Survival was compared between RASHN and dnSHN. RESULTS The risk of RASHN was 20.0 per 100,000 person-years. The average latency period was 124.2 months (range 38-329). The cumulative incidence of RASHN at 20 years was 0.13%. Oral cavity and oropharynx primaries demonstrate increased risk. Five-year overall survival of RASHN was 22.4% compared to 64.5% for dnSHN. CONCLUSIONS RASHN are confirmed to be rare. RASHN have poor overall survival and worse survival compared to dnSHN. The impact of intensity-modulated radiation therapy protocols on this risk is unknown. Modifiable risk factors of smoking and alcohol consumption continue to dwarf radiation therapy as risk factors of second primary head and neck cancers. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Joshua B Smith
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
| | - Lauren M Cass
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, U.S.A
| | - Gregory M Ward
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
| | - Sean T Massa
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
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11
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Snow A, Ring A, Struycken L, Mack W, Koç M, Lang JE. Incidence of radiation induced sarcoma attributable to radiotherapy in adults: A retrospective cohort study in the SEER cancer registries across 17 primary tumor sites. Cancer Epidemiol 2021; 70:101857. [PMID: 33249363 PMCID: PMC7856279 DOI: 10.1016/j.canep.2020.101857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/13/2020] [Accepted: 11/01/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Previous studies have noted the incidence of radiation-induced sarcomas (RIS) but have not investigated the relative risk (RR) of developing RIS based on primary tumor organ disease site. By examining data from the Surveillance, Epidemiology, and End Results (SEER) database, we hypothesized that breast cancer would have a higher incidence of RIS compared to seventeen other primary cancer sites. METHODS This was a retrospective cohort study that examined patients from SEER registries between 1973 and 2013. We included patients aged 18 years or older who were diagnosed with cancer and those diagnosed with a cancer who subsequently developed a sarcoma. We excluded patients with missing information on initial radiotherapy treatment or stage. RIS was defined as those who developed a secondary sarcoma near the site of their original malignancy and after a 24-month latency period. RESULTS Our patients had a mean age of 60 years and follow up time of 9.2 years. Breast cancer comprised the majority with 693,701(36.8%) patients of which 161 (0.02%) had a secondary sarcoma. Of the 359 patients with secondary sarcomas, 242 (67.4%) had RIS. Breast cancer had the highest number of RIS patients at 126 compared to all combined non-breast cancer sites at 116. The RR of RIS in breast cancer versus 19 other primary cancer sites was 1.21 (CI: 1.01-1.45, p < 0.03, adjusted for age at primary diagnosis, gender, and latency). CONCLUSIONS Our study demonstrated that breast cancer has a higher risk of developing RIS compared to other solid cancers.
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Affiliation(s)
- Anson Snow
- Division of Medical Oncology, Department of Medicine, University of Southern California, Los Angeles, CA, USA; USC California Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Alexander Ring
- Department of Medical Oncology and Haematology, University Hospital Zurich, and University of Zurich, Zurich, Switzerland
| | - Lucas Struycken
- Division of Medical Oncology, Department of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Radiology, Department of Medical Imaging, University of Arizona Banner University Medical Center, Tucson, Arizona, USA
| | - Wendy Mack
- Department of Preventive Medicine, SC Clinical Translational Science Institute, University of Southern California, Los Angeles, CA, USA
| | - Melissa Koç
- Department of Preventive Medicine, SC Clinical Translational Science Institute, University of Southern California, Los Angeles, CA, USA
| | - Julie E Lang
- USC California Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA; Division of Surgical Oncology, Department of Surgery and University of Southern California Norris Cancer Center, University of Southern California, Los Angeles, CA, USA.
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12
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Lou J, Jiang L, Dai X, Wang H, Yang J, Guo L, Fang M, Wang S. Radiation-Induced Sarcoma of the Head and Neck Following Radiotherapy for Nasopharyngeal Carcinoma: A Single Institutional Experience and Literature Review. Front Oncol 2021; 10:526360. [PMID: 33552942 PMCID: PMC7858657 DOI: 10.3389/fonc.2020.526360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/26/2020] [Indexed: 12/25/2022] Open
Abstract
Background and Objective Radiotherapy (RT) is the primary treatment option for nasopharyngeal carcinoma (NPC), but it is associated with radiation-induced sarcomas (RISs). This study aims to investigate clinicopathological features and head and neck RIS prognosis after NPC RT. Methods The medical and radiological records of the NPC patients (n =14,074) referred to Zhejiang Cancer Hospital, Hang Zhou, China between January 1995 and December 2018 were retrospectively reviewed. Among them, 22 patients were determined to have RIS after RT for NPC. The clinicopathological data, diagnosis, treatment, and follow-up results of 22 patients with RIS were analyzed in this retrospective research. All 22 patients underwent surgery as the main treatment. The levels of Overall Survival (OS) were determined through the Log-rank test and Kaplan-Meier method. Results Among these patients, 13 were males and nine females with the male/female ratio of 1.44:1. The age during the primary RT of NPC ranged from 25 to 61 years old (median age: 37 years old). Patients' ages ranged from 33 to 73 years old (median age: 52.5 years old) when diagnosed with RIS. The latency period for development of the RIS was between 3 and 36 years (median: 8.5 years) after RT. In this cohort, R0 resection was achieved in 13 cases, R1 resection in five cases, and R2 resection in four cases. During the follow-up period ranged from 2 to 102 months (median 14 months), 15 patients had died of the disease. Kaplan-Meier method showed that the 2-year, 3-year, and the 5-year cumulative OS rate was 50.3, 43.2, and 14.4%, respectively. The median survival time was 34 months. Surgical resection with R0 resection achieves a significantly better prognosis (P = 0.012). Patients under the age of 37 years old at the time of initial RT had a relatively better prognosis (P = 0.035). Conclusions Although the incidence of RIS after RT of NPC is generally low, the treatment of RIS is very difficult. The RISs are associated with poor overall prognosis. R0 resection can improve the prognosis thus it should be considered as the primary and optimal choice for the treatment of RIS.
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Affiliation(s)
- Jianlin Lou
- Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Lin Jiang
- Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Xinshen Dai
- Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.,Zhejiang Chinese Medical University, Hangzhou, China
| | - Huanhuan Wang
- Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.,Zhejiang Chinese Medical University, Hangzhou, China
| | - Jia Yang
- Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.,Zhejiang Chinese Medical University, Hangzhou, China
| | - Liang Guo
- Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Meiyu Fang
- Department of Medical Oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shengye Wang
- Department of Radiotherapy, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
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13
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Chen TWW, Burns J, Jones RL, Huang PH. Optimal Clinical Management and the Molecular Biology of Angiosarcomas. Cancers (Basel) 2020; 12:E3321. [PMID: 33182685 PMCID: PMC7696056 DOI: 10.3390/cancers12113321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022] Open
Abstract
Angiosarcomas comprise less than 3% of all soft tissue sarcomas but have a poor prognosis. Most angiosarcomas occur without obvious risk factors but secondary angiosarcoma could arise after radiotherapy or chronic lymphedema. Surgery remains the standard treatment for localized angiosarcoma but neoadjuvant systemic treatment may improve the curability. For advanced angiosarcoma, anthracyclines and taxanes are the main chemotherapy options. Anti-angiogenic agents have a substantial role but the failure of a randomized phase 3 trial of pazopanib with or without an anti-endoglin antibody brings a challenge to future trials in angiosarcomas. Immune checkpoint inhibitors as single agents or in combination with oncolytic virus may play an important role but the optimal duration remains to be investigated. We also report the current understanding of the molecular pathways involved in angiosarcoma pathogenesis including MYC amplification, activation of angiogenic pathways and different molecular alterations that are associated with angiosarcomas of different aetiology. The success of the patient-partnered Angiosarcoma Project (ASCProject) has provided not only detailed insights into the molecular features of angiosarcomas of different origins but also offers a template for future fruitful collaborations between patients, physicians, and researchers. Lastly, we provide our perspective of future developments in optimizing the clinical management of angiosarcomas.
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Affiliation(s)
- Tom Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital and Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Jessica Burns
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK;
| | - Robin L. Jones
- Sarcoma Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London SW3 6JJ, UK;
| | - Paul H. Huang
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK;
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14
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Nguyen TH, Makena MR, Yavvari S, Kaur M, Pham T, Urias E, Panapitiya N, Al-Rahawan MM. Sarcoma as Second Cancer in a Childhood Cancer Survivor: Case Report, Large Population Analysis and Literature Review. ACTA ACUST UNITED AC 2020; 56:medicina56050224. [PMID: 32392854 PMCID: PMC7279476 DOI: 10.3390/medicina56050224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/25/2022]
Abstract
The majority of pediatric patients are cured of their primary cancer with current advanced developments in pediatric cancer therapy. However, survivors often experience long-term complications from therapies for primary cancer. The delayed mortality rate has been decreasing with the effort to reduce the therapeutic exposure of patients with pediatric cancers. Our study investigates the incidence of sarcoma as second cancer in pediatric cancer survivors. We present a 9-year-old male who survived embryonal hepatoblastoma diagnosed at 22 months of age. At 4.5 years of age, he presented with a non-metastatic primitive neuroectodermal tumor (PNET) of the left submandibular area. He has no evidence of recurrence of either cancer for 51 months after finishing all chemotherapy and radiotherapy. We used the Surveillance, Epidemiology, and End Results (SEER) database to identify the current rate of second sarcomas in pediatric cancer survivors. Our literature review and large population analysis emphasize the impact of sarcoma as a second malignancy and provide help to physicians caring for pediatric cancer survivors.
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Affiliation(s)
- Thinh H. Nguyen
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Monish Ram Makena
- Department of Physiology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA;
| | - Siddhartha Yavvari
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, Usual;
| | - Maninder Kaur
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Teresia Pham
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Eduardo Urias
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Narendra Panapitiya
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Mohamad M. Al-Rahawan
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
- Correspondence:
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15
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Shibahara D, Furugen M, Kasashima S, Kaneku K, Yamashiro T, Arakaki W, Ariga T, Atsumi E, Aoyama H, Matsumoto H, Maehara H, Fujita J. Radiation-induced sarcoma in a 10-year survivor with stage IV EGFR-mutated lung adenocarcinoma. Respir Med Case Rep 2019; 28:100889. [PMID: 31304084 PMCID: PMC6604042 DOI: 10.1016/j.rmcr.2019.100889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 12/05/2022] Open
Abstract
A 70-year-old Japanese man with stage IV EGFR-mutated lung adenocarcinoma complained of right mild back pain. The patient had been heavily treated with several cytotoxic or molecular targeted agents for 10 years and received a palliative radiation therapy of 2nd sacral vertebra 5 years ago. Computed tomography showed the abnormal lesion in right iliopsoas muscle. A pathological examination confirmed undifferentiated pleomorphic sarcoma, consistent with the diagnosis of radiation-induced sarcoma (RIS). Since RIS is a rare late-onset complication of radiation therapy, to our knowledge, this is the first report of RIS that was associated with advanced lung cancer and detected after palliative radiation therapy. The careful long-term follow-up is thus necessary even after palliative radiation therapy and we have to be aware of the existence of RIS.
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Affiliation(s)
- Daisuke Shibahara
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Makoto Furugen
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Shiho Kasashima
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Kozue Kaneku
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Tomoko Yamashiro
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Wakako Arakaki
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Takuro Ariga
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Eriko Atsumi
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.,Department of Pathology, National Hospital Organization, Okinawa National Hospital, 3-20-14, Ganeko, Ginowan, Okinawa, 901-2214, Japan
| | - Hajime Aoyama
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Hirofumi Matsumoto
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Hiroki Maehara
- Hyperbaric Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0125, Japan
| | - Jiro Fujita
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
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16
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Giannini L, Incandela F, Fiore M, Gronchi A, Stacchiotti S, Sangalli C, Piazza C. Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature. Front Oncol 2018; 8:449. [PMID: 30386739 PMCID: PMC6199463 DOI: 10.3389/fonc.2018.00449] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/24/2018] [Indexed: 12/29/2022] Open
Abstract
In the last decades, radiotherapy (RT) has become one of the cornerstones in the treatment of head and neck (HN) malignancies and has paralleled an increase in long-term patient survival. This lead to a concomitant increase in the incidence of radiation-induced sarcomas (RIS) of the irradiated field, with an annual rate up to 0.17%. The new techniques of irradiation do not seem to influence the risk of RIS of the HN (RISHN), which mainly develop within the middle-dose field. The median latency of RISHN after RT is 10–12 years and osteosarcoma is the most represented histotype, even though there is a high variability in time of occurrence and histological features observed. There is no clear evidence of predisposing factors for RISHN, and genetic findings so far have not revealed any common mutation. Early clinical diagnosis of RISHN is challenging, since it usually occurs within fibrotic and hardened tissues, while radiological findings are not pathognomonic and able to differentiate them from other neoplastic entities. Given the highly aggressive behavior of RISHN and its poor sensitivity to chemotherapy, radical surgery is the most important prognostic factor and the only curative option at present. Nevertheless, the anatomy of the HN district and the infiltrative nature of RIS do not always allow radical intervention. Therefore, a wise integration with systemic therapy and, when feasible, re-irradiation should be performed. Future findings in the genomic features of RISHN will be crucial to identify a possible sensitivity to specific drugs in order to optimize a multimodal treatment that will be ideally complementary to surgery and re-irradiation.
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Affiliation(s)
- Lorenzo Giannini
- Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy.,Department of Otorhinolaryngology-Head and Neck Surgery, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Fabiola Incandela
- Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy
| | - Marco Fiore
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS National Cancer Institute of Milan, Milan, Italy
| | - Alessandro Gronchi
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS National Cancer Institute of Milan, Milan, Italy
| | - Silvia Stacchiotti
- Adult Mesenchymal and Rare Tumor Medical Oncology Unit, Department of Medicine, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy
| | - Claudia Sangalli
- Department of Radiotherapy, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy
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17
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Katzilakis N, Tsirigotaki M, Stratigaki M, Kampouraki E, Athanasopoulos EM, Erasmia A, Kattamis A, Stiakaki E. Second Malignant Neoplasms in Children and Adolescents Treated for Blood Malignancies and Solid Tumors: A Single-Center Experience of 15 Years. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_102_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Context: The occurrence of second malignancies is not rare in children treated for primary tumors. Objectives: The aim of this study was to investigate the occurrence and the outcomes of second malignancies in children and adolescents from a large tertiary pediatric hematology-oncology center. Materials and Methods: A retrospective study was performed looking into the characteristics and outcomes of second malignant neoplasms in children and adolescents treated for primary malignancies in a single center over a 15-year period. Results: Among 270 children and adolescents treated for hematological malignancies and solid tumors from 2000 to 2015, five cases of second malignancy were diagnosed including cancer of the parotid gland, renal cell carcinoma, Hodgkin’s lymphoma, thyroid carcinoma, and transitional liver cell carcinoma in patients previously treated for acute myeloid leukemia, glioblastoma multiforme, B-acute lymphoblastic leukemia, Langerhans cell histiocytosis, and medulloblastoma, respectively. Primary malignancies were treated with chemotherapy in all cases and four out of five patients had also received radiotherapy. Mean age at diagnosis of second malignancy was 10 years and 4 months. Overall survival after diagnosis of second malignancy was 80% at 12 months and 75% at 5 years. Conclusions: Close surveillance and long-term follow-up are mandatory for the identification of late effects in children treated for malignancy.
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Affiliation(s)
- Nikolaos Katzilakis
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion
| | - Maria Tsirigotaki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion
| | - Maria Stratigaki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion
| | - Eleni Kampouraki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion
| | | | - Athina Erasmia
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion
| | - Antonis Kattamis
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Athens, Aghia Sofia Children’s Hospital, Athens, Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion
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18
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Salminen SH, Sampo MM, Böhling TO, Tuomikoski L, Tarkkanen M, Blomqvist CP. Radiation-associated sarcoma after breast cancer in a nationwide population: Increasing risk of angiosarcoma. Cancer Med 2018; 7:4825-4835. [PMID: 30044058 PMCID: PMC6143936 DOI: 10.1002/cam4.1698] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/30/2018] [Accepted: 07/02/2018] [Indexed: 12/14/2022] Open
Abstract
Radiation‐associated sarcoma (RAS) is a rare complication of radiation therapy (RT) to breast cancer (BC). This study explored RAS after RT to BC in a nationwide population‐based material. The Finnish Cancer Registry was queried for patients with BC treated during 1953‐2014 who were later diagnosed with a secondary sarcoma in 1953‐2014. Registry data, patient files, and sarcoma specimens were analyzed to confirm diagnosis and location of RAS at or close to the RT target volume. A total of 132 512 patients were diagnosed with invasive BC during the study period. A subsequent sarcoma was diagnosed in 355 patients. After exclusion, 96 RAS were identified. Angiosarcoma (AS) was the most prevalent histology in 50 (52%) of 96 patients. However, the first radiation‐associated AS was diagnosed in a patient treated for BC with breast‐conserving surgery in 1984, and thereafter, the proportion of AS continuously increased. The 5‐year sarcoma‐specific survival was 75.1% for RAS treated with a curative intent. The distribution of histologic subtypes of RAS has changed during the 60 years of this registry study. The first radiation‐associated AS was diagnosed in 1989, and presently, AS is the most common histologic subtype of RAS. It is possible that changes in BC treatment strategies are influencing the characteristics of RAS.
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Affiliation(s)
- Samuli H Salminen
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | - Mika M Sampo
- Department of Pathology, University of Helsinki and HUSLAB Helsinki University Hospital, Helsinki, Finland
| | - Tom O Böhling
- Department of Pathology, University of Helsinki and HUSLAB Helsinki University Hospital, Helsinki, Finland
| | - Laura Tuomikoski
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | - Maija Tarkkanen
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | - Carl P Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland.,Department of Oncology, Örebro University Hospital, Örebro, Sweden
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