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Br J Cancer. 2017 Jul 25;117(3):326-331. doi: 10.1038/bjc.2017.198. Epub 2017 Jun 27.

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

Author information

1
The University of Sydney, Sydney 2006, Australia.
2
Chris O'Brien Lifehouse, Sydney 2050, Australia.
3
Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
4
Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada.
5
Department of Surgery, University of Toronto, Toronto, ON M5S, Canada.
6
Centre Léon Bérard, University Claude Bernard, Lyon 69100, France.
7
The Royal Orthopaedic Hospital NHS Trust, Birmingham B31 2AP, UK.
8
National Cancer Centre, Singapore 169610, Singapore.
9
NHMRC Clinical Trials Centre, University of Sydney, Sydney 2006, Australia.

Abstract

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.

PMID:
28654633
PMCID:
PMC5537501
DOI:
10.1038/bjc.2017.198
[Indexed for MEDLINE]
Free PMC Article

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