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Multicenter Study
. 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

A Y Zhang  1   2 , I Judson  3 , C Benson  3 , J S Wunder  4   5 , I Ray-Coquard  6 , R J Grimer  7 , R Quek  8 , E Wong  3 , A B Miah  3 , P C Ferguson  4   5 , A Dufresne  6 , J Y H Teh  8 , M Stockler  2   9 , M H N Tattersall  1   2
Affiliations
Multicenter Study

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

A Y Zhang et al. Br J Cancer. .

Erratum in

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.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Kaplan–Meier estimates of radiation-induced sarcoma-free survival by chemotherapy use for all patients in the study cohort; (B) Kaplan–Meier estimates of radiation-induced sarcoma-free survival by (B1) anthracycline and (B2) alkylating chemotherapy use in the Léon Bérard and Mount Sinai Hospital cohorts.
See this image and copyright information in PMC

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