Cancer treatments-related factors for subsequent soft-tissue sarcoma in childhood cancer survivors

BACKGROUND: Previous studies of risk factors for subsequent soft-tissue sarcoma (STS) among childhood cancer survivors had small numbers and were unable to comprehensively investigate the dose-response relationships with radiation from radiotherapy and with cumulative exposure to specific cytotoxics. PATIENTS AND METHODS: ) were calculated to assess dose-response relationships. RESULTS: , the OR was 4.7 [95% CI 1.3-25.1] compared with non-exposure after controlling for radiation. No association was found for other alkylating agents or other specific cytotoxic drugs. CONCLUSION: Although high radiation doses remain the primary risk factor for secondary STS, our findings suggest a possible increase in risk at lower doses (5-9 Gy) and following procarbazine treatment among childhood cancer survivors. These observations warrant further investigation and may merit consideration in treatment planning and long-term follow-up guidelines for cancer survivors.