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

A. Y. Zhang; I. Judson; C. Benson; J. S. Wunder; I. Ray-Coquard; R. J. Grimer; R. Quek; E. Wong; A. B. Miah; P. C. Ferguson; A. Dufresne; J. Y. H. Teh; M. Stockler; M. H. N. Tattersall

doi:10.1038/bjc.2017.198

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

A. Y. Zhang^*, I. Judson, C. Benson, J. S. Wunder, I. Ray-Coquard, R. J. Grimer, R. Quek, E. Wong, A. B. Miah, P. C. Ferguson, A. Dufresne, J. Y. H. Teh, M. Stockler, M. H. N. Tattersall

^*Corresponding author for this work

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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.

Original language	English
Pages (from-to)	326-331
Number of pages	6
Journal	British Journal of Cancer
Volume	117
Issue number	3
DOIs	https://doi.org/10.1038/bjc.2017.198 https://doi.org/10.1038/s41416-018-0079-9
Publication status	Published - 25 Jul 2017
Externally published	Yes

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Copyright 2017 Cancer Research UK. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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Zhang, A. Y., Judson, I., Benson, C., Wunder, J. S., Ray-Coquard, I., Grimer, R. J., Quek, R., Wong, E., Miah, A. B., Ferguson, P. C., Dufresne, A., Teh, J. Y. H., Stockler, M., & Tattersall, M. H. N. (2017). Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study. British Journal of Cancer, 117(3), 326-331. https://doi.org/10.1038/bjc.2017.198, https://doi.org/10.1038/s41416-018-0079-9

Zhang, A. Y. ; Judson, I. ; Benson, C. ; Wunder, J. S. ; Ray-Coquard, I. ; Grimer, R. J. ; Quek, R. ; Wong, E. ; Miah, A. B. ; Ferguson, P. C. ; Dufresne, A. ; Teh, J. Y. H. ; Stockler, M. ; Tattersall, M. H. N. / Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas : a multicenter study. In: British Journal of Cancer. 2017 ; Vol. 117, No. 3. pp. 326-331.

@article{e8351cb80f2c4a04884bd76ec06fdb60,

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

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.",

author = "Zhang, {A. Y.} and I. Judson and C. Benson and Wunder, {J. S.} and I. Ray-Coquard and Grimer, {R. J.} and R. Quek and E. Wong and Miah, {A. B.} and Ferguson, {P. C.} and A. Dufresne and Teh, {J. Y. H.} and M. Stockler and Tattersall, {M. H. N.}",

note = "Copyright 2017 Cancer Research UK. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2017",

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day = "25",

doi = "10.1038/bjc.2017.198",

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Zhang, AY, Judson, I, Benson, C, Wunder, JS, Ray-Coquard, I, Grimer, RJ, Quek, R, Wong, E, Miah, AB, Ferguson, PC, Dufresne, A, Teh, JYH, Stockler, M & Tattersall, MHN 2017, 'Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study', British Journal of Cancer, vol. 117, no. 3, pp. 326-331. https://doi.org/10.1038/bjc.2017.198, https://doi.org/10.1038/s41416-018-0079-9

Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas : a multicenter study. / Zhang, A. Y.; Judson, I.; Benson, C.; Wunder, J. S.; Ray-Coquard, I.; Grimer, R. J.; Quek, R.; Wong, E.; Miah, A. B.; Ferguson, P. C.; Dufresne, A.; Teh, J. Y. H.; Stockler, M.; Tattersall, M. H. N.

In: British Journal of Cancer, Vol. 117, No. 3, 25.07.2017, p. 326-331.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas

T2 - a multicenter study

AU - Zhang, A. Y.

AU - Judson, I.

AU - Benson, C.

AU - Wunder, J. S.

AU - Ray-Coquard, I.

AU - Grimer, R. J.

AU - Quek, R.

AU - Wong, E.

AU - Miah, A. B.

AU - Ferguson, P. C.

AU - Dufresne, A.

AU - Teh, J. Y. H.

AU - Stockler, M.

AU - Tattersall, M. H. N.

N1 - Copyright 2017 Cancer Research UK. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2017/7/25

Y1 - 2017/7/25

N2 - 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.

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

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