Sarcoma after radiation therapy: Retrospective multiinstitutional study of80 histologically confirmed cases

PURPOSE: To evaluate the best strategy for treatment of sarcoma that occurs after radiation therapy. MATERIALS AND METHODS: Records were retrospectively reviewed for 80 patient s with a confirmed histologic diagnosis of sarcoma that occurred after radi ation therapy performed during 1975-1995. The patients were treated for bre ast cancer(n = 33, 42%), non-Hodgkin lymphoma (n = 9, 11%), cervical cancer (n = 9, 11%), benign lesions (n = 4, 5%), or other tumors (n = 25, 31%). Sa rcoma occurred after a mean latency of 12 years (range, 3-64 years), with m ost (70%) developing in the soft tissue. Treatment included surgery (28 pat ients), surgery and chemotherapy (18 patients), chemotherapy only (15 patie nts), and radiation therapy (14 patients). RESULTS: By the end of the study, 51 patients were dead, including 46 due t o sarcoma. Median survival was 23 months. Overall survival rates at 2 and 5 years, respectively, were 69% and 39% for patients treated with surgery, 1 0% and 0% for those treated with chemotherapy, and 52% and 35% for those tr eated with surgery and chemotherapy (P =.001). The 2- and 5-year rates for survival without recurrence were 54% and 32%, respectively. CONCLUSION: The results confirm the beneficial effect of surgery. Further s tudy is needed to explore the roles of combined treatments.