Two cases of secondary soft tissue sarcomas after radiotherapy and radiochemotherapy

Our plain-English summary of Two cases of secondary soft tissue sarcomas after radiotherapy and radiochemotherapy, by C. Saggia, G. Forti, G. Biaggi, et al (Tumori, 2004).

The study

• Authors: C. Saggia, G. Forti, G. Biaggi, S. Lattuada, A. Santagostino, G. Angeli, M.C. Pollo, M.E. Negru, O. Alabiso
• Journal: Tumori
• Published: 2004;90(6):622-4
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The development of secondary soft tissue sarcomas after chemo-radiotherapy is a rare and little known event, but its frequency is increasing.

Patients And Methods: We report two cases of secondary soft tissue sarcomas. The first is the case of a 51-year-old woman treated for Hodgkin's disease with chemotherapy and radiotherapy 15 years before she developed a high-grade malignant pleural sarcoma. The patient had no history of asbestos exposure. The second is the case of a 64-year-old woman with a giant cell malignant histiocytoma secondary to colorectal cancer treated with surgery and radiotherapy nine years before. The patients were not eligible for surgery or radiotherapy. Both were treated with chemotherapy (ifosfamide and epirubicin) without any relevant secondary effects; however, the response to therapy was poor.

Conclusions: The causes of secondary malignancies are multifactorial, but radiation therapy and chemotherapy are certainly implicated in the development of post-therapy neoplasms that are difficult to treat.

In plain English

This article reported two women who developed soft tissue sarcomas years after treatment for an earlier cancer. The first, a 51-year-old, had been treated in 1987 for Hodgkin's disease with three courses of MOPP chemotherapy and total nodal irradiation (40 Gy). In July 2002 she was diagnosed with a high-grade pleural sarcoma. The article states she had no history of asbestos exposure. She received ifosfamide and epirubicin chemotherapy. Her response could not be assessed because she died of respiratory distress, and she survived only five months. The second, a 64-year-old, had surgery for rectal carcinoma in 1992 and pelvic radiotherapy (45 Gy plus a 14 Gy perineal boost) in 1993. In December 2002 a biopsy of a pelvic mass showed malignant fibrous histiocytoma with giant cells. After three cycles of the same two drugs she had grade 4 blood toxicity, which resolved. Her latest evaluation showed a more necrotic mass, greatly reduced in size. The authors concluded that both sarcomas were very aggressive and that chemotherapy, the only possible treatment, gave poor results. In their view these tumors have many causes, but radiotherapy and chemotherapy play an important role.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (two cases)
• Who was studied: Two women treated in Italy: a 51-year-old previously treated for Hodgkin's disease (stage IIIA), and a 64-year-old previously treated for rectal carcinoma
• Exposure: Earlier cancer treatment, not asbestos. Case 1: three courses of MOPP chemotherapy and total nodal irradiation (40 Gy, October 1987 to December 1988), with no history of asbestos exposure. Case 2: surgery in 1992 and pelvic radiotherapy of 45 Gy plus a 14 Gy perineal boost in February 1993
• Main results:
  • Case 1: diagnosis of high-grade pleural sarcoma in July 2002, 15 years after the onset of Hodgkin's disease; the tumor was CD34-positive
  • Case 1: response to ifosfamide and epirubicin could not be assessed because the patient died of respiratory distress due to a bronchoesophageal fistula
  • Case 1: the patient survived only five months
  • Case 2: biopsy in December 2002 showed malignant fibrous histiocytoma with giant cells; the mass had grown to 50 x 70 mm
  • Case 2: three cycles of ifosfamide and epirubicin caused grade 4 hematological toxicity, which resolved after G-CSF and antibiotics
  • Case 2: the latest evaluation showed a more necrotic mass that was greatly reduced in size
• The authors' conclusion: The authors concluded that both sarcomas were very aggressive, that chemotherapy was the only possible treatment and that the results were poor. They stated that these tumors have a multifactorial origin but that radiotherapy and chemotherapy certainly play an important role.

Topics

Medical terms in this study, explained in our Lexicon: Sarcoma, Chemotherapy, Asbestos Exposure, Colorectal Cancer, Neoplasm.

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• Pleural mesothelioma secondary to radiotherapy: a rare association — T. Lourido-Cebreiro, V. Leiro-Fernández, et al. (2012)
• The diversity of soft tissue tumours with EWSR1 gene rearrangements: a review — C. Fisher (2014)

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