Radiation-Induced Sarcoma

Abstract

One of the few known causes of sarcomas is therapeutic irradiation. Therapeutic radiation has also been associated with development of breast cancer, lung cancer, and accelerated coronary artery disease in patients receiving thoracic radiation [1–3]. With the increased recognition of second cancers as a long-term side effect of radiation therapy, attempts have been made to use radiation more sparingly. For example, there is a question as to whether surgery for ductal carcinoma in situ is necessary, whereas at least one present standard of care is lumpectomy and radiation therapy, despite the ability to obtain negative margins in at least 95 % of patients with surgery alone, and no difference in long-term breast cancer mortality with the addition of radiation therapy [4, 5]. The incidence of a sarcoma after radiation is not precisely known, and may vary from one part of the body to the next. In a series of patients treated for cancer of all sites in Finland, for example, the crude risk was of the order of 0.05 % [6].