Radiation-induced sarcoma of bone

Abstract

During the period 1931 to 1970, 50 cases of radiation-induced osteogenic sarcoma were seen at the Memorial and James Ewing Hospitals. Twenty-two of these cases had previously been described; the present paper adds an additional 28 cases to the existing series and reviews those factors related to the development of neoplastic changes. In 35 patients, there was evidence of preexisting bone pathology in the form of benign osseous growths. Fifteen patients had soft-part and visceral neoplasms, such as retinoblastoma, seminoma, and breast carcinoma, the involved bone lying in the pathway of the radiation beam. Symptoms ranged from a palpable tender mass in the involved bone to intestinal obstruction secondary to metastatic radiation-induced osteogenic sarcoma. Essentially all bones in the skeletal system appear to have been vulnerable. The radiation dosages ranged from 1,200 rads given in a few weeks to 24,000 rads given in 2 years. Induction time covered a period of 4 through 30 years with a mean of 9 years. Thirty-two of the patients developing this neoplasm have since died of their disease.