Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study.

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Date
2017-07Author
Zhang, AY
Judson, I
Benson, C
Wunder, JS
Ray-Coquard, I
Grimer, RJ
Quek, R
Wong, E
Miah, AB
Ferguson, PC
Dufresne, A
Teh, JYH
Stockler, M
Tattersall, MHN
Type
Journal Article
Metadata
Show full item recordAbstract
Background An increasing number and proportion of cancer patients with apparently localised disease are treated with chemotherapy and radiation therapy in contemporary oncology practice. In a pilot study of radiation-induced sarcoma (RIS) patients, we demonstrated that chemotherapy was associated with a reduced time to development of RIS. We now present a multi-centre collaborative study to validate this association.Methods This was a retrospective cohort study of RIS cases across five large international sarcoma centres between 1 January 2000 to 31 December 2014. The primary endpoint was time to development of RIS.Results We identified 419 patients with RIS. Chemotherapy for the first malignancy was associated with a shorter time to RIS development (HR 1.37; 95% CI: 1.08-1.72; P=0.009). In the multi-variable model, older age (HR 2.11; 95% CI 1.83-2.43; P<0.001) and chemotherapy for the first malignancy (HR 1.61; 95% CI 1.26-2.05; P<0·001) were independently associated with a shorter time to RIS. Anthracyclines and alkylating agents significantly contribute to the effect.Conclusions This study confirms an association between chemotherapy given for the first malignancy and a shorter time to development of RIS.
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Subject
Humans
Neoplasms
Sarcoma
Neoplasms, Radiation-Induced
Neoplasms, Second Primary
Anthracyclines
Antineoplastic Agents
Antineoplastic Agents, Alkylating
Retrospective Studies
Age Factors
Time Factors
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Child
Child, Preschool
Infant
Female
Male
Young Adult
Research team
Sarcoma Clinical Trials
Language
eng
Date accepted
2017-06-05
License start date
2017-07
Citation
British journal of cancer, 2017, 117 (3), pp. 326 - 331