Patterns of Care and Outcome Radiation-Induced Soft Tissue Sarcomas

Purpose: Radiation therapy is used as a radical treatment for many cancers and is delivered in the neoadjuvant or adjuvant setting, frequently combined with other treatment modalities such as chemotherapy and surgery. However, radiation exposure is a well established risk factor for developing secondary malignancies. Soft-tissue sarcomas are the most common types of radiation-induced tumors in the general population. Methods: We have analyzed 510 patients from the French Sarcoma Group database. Prognostic factors for locoregional-free Survival (LRFS), metastases-free survival (MFS), and overall Survival (OS) were identified by univariate and multivariate analyses using a Cox regression model. Results: Median overall survival for patients M0 with R0/R1 surgery was 65.1 months (95% CI, 50.0-98.4). The 5-year and 10-year OS rates were 52.9% (47.1-58.2) and 41.0% (34.2-47.7), respectively. On multivariate analysis, the predictors of worse OS were age, R1 margin status, grade 3 and size >55 mm. Conclusions: We report here the largest series of patients with radiation-induced soft-tissue sarcomas. We demonstrate that a majority of patients can be cured provided they are managed with adequate surgery.