Systemic Treatment Options for Radiation-Associated Sarcomas
- 27 June 2014
- journal article
- research article
- Published by Springer Science and Business Media LLC in Current Treatment Options in Oncology
- Vol. 15 (3), 476-481
- https://doi.org/10.1007/s11864-014-0299-z
Abstract
Sarcomas are rare malignant tumors that develop from mesenchymal tissue. Most sarcomas are idiopathic, however, a significant minority develops as a consequence of prior radiation exposure. Although the absolute risk of developing a radiation-associated sarcoma is small, these tumors represent significant clinical challenges. For recurrent, unresectable or metastatic disease, the standard treatment is systemic chemotherapy. Radiation-associated sarcomas tend to be undifferentiated sarcomas, angiosarcomas, or leiomyosarcomas, which are variably sensitive to chemotherapy. The best general approach is to treat each radiation-associated sarcoma as one would its sporadic histologic counterpart. There are limited data to guide the best treatment for radiation-associated sarcoma, therefore, the standard chemotherapy options are reasonable choices. These include doxorubicin, ifosfamide, gemcitabine, docetaxel, and pazopanib. Patients with radiation-associated sarcomas may have received prior anthracyclines to treat antecedent malignancies such as breast cancer or lymphoma. Thus, if additional doxorubicin cannot be used, liposomal doxorubicin is a reasonable substitute. More prospective research is needed on how radiation-associated sarcomas respond to systemic therapy. Future clinical trials of new agents in sarcoma should identify and include patients with radiation-associated sarcoma.Keywords
This publication has 22 references indexed in Scilit:
- Randomized Multicenter and Stratified Phase II Study of Gemcitabine Alone Versus Gemcitabine and Docetaxel in Patients with Metastatic or Relapsed Leiomyosarcomas: A Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) French Sarcoma Group Study (TAXOGEM study)The Oncologist, 2012
- The clinical and functional outcome for patients with radiation‐induced soft tissue sarcomaCancer, 2011
- Advances in sarcoma genomics and new therapeutic targetsNature Reviews Cancer, 2011
- Efficacy and Safety of Trabectedin in Patients With Advanced or Metastatic Liposarcoma or Leiomyosarcoma After Failure of Prior Anthracyclines and Ifosfamide: Results of a Randomized Phase II Study of Two Different SchedulesJournal of Clinical Oncology, 2009
- Pazopanib, a Multikinase Angiogenesis Inhibitor, in Patients With Relapsed or Refractory Advanced Soft Tissue Sarcoma: A Phase II Study From the European Organisation for Research and Treatment of Cancer–Soft Tissue and Bone Sarcoma Group (EORTC Study 62043)Journal of Clinical Oncology, 2009
- Phase II Study of Sorafenib in Patients With Metastatic or Recurrent SarcomasJournal of Clinical Oncology, 2009
- Phase II Trial of Weekly Paclitaxel for Unresectable Angiosarcoma: The ANGIOTAX StudyJournal of Clinical Oncology, 2008
- Randomized Phase II Study of Gemcitabine and Docetaxel Compared With Gemcitabine Alone in Patients With Metastatic Soft Tissue Sarcomas: Results of Sarcoma Alliance for Research Through Collaboration Study 002Journal of Clinical Oncology, 2007
- Gemcitabine and vinorelbine combination chemotherapy for patients with advanced soft tissue sarcomasCancer, 2007
- Long-term Results With Resection of Radiation-Induced Soft Tissue SarcomasAnnals of Surgery, 2004