With cancer incidence increasing annually and patients living longer after effective treatment the number of post-radiation sarcomas are increasing. These sarcomas are challenging to treat and have a worse prognosis than their similarly named sarcoma that is not associated with radiation exposure. The majority are high grade tumors and require aggressive multi-modal treatment. A complete surgical resection is paramount to having a good outcome and chemotherapy and radiation therapy are used as adjuvants when possible. The risk of developing a sarcoma from radiation exposure is dependent on the total dose received and typically a long time period from when radiation was received (>10-20 years).
One of the biggest challenges in clinical practice is explaining to patients who have a high-grade soft tissue sarcoma that we are recommending radiation therapy and surgical resection. The same exposure that is a known risk factor for developing a sarcoma is effective in treating some sarcomas. Radiation for soft tissue sarcomas can be delivered pre-surgically or after resection of the mass. The main reason we choose to administer pre-operative radiation therapy for high-grade soft tissue sarcomas at Albany Medical Center is because the dose is lower (50Gy) and the field of treatment is smaller. The trade off for few radiation associated long term problems is a higher incidence in post operative wound problems many of which require surgical treatment.
A recent article in the link below gives an Update on the clinical, histologic and molecular features of Radiation-induced sarcomas. Please share any questions in the comment section.
