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.

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Journal
ESMO Open
Published
2026-07-24
DOI
https://doi.org/10.1016/j.esmoop.2026.108313
Primary Topic
Sarcoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00

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article

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

Peter Kaatsch, Daniel Bejarano‐Quisoboni, C. J. Bright, Helena J. H. van der Pal et al.
ESMO Open
Sarcoma Diagnosis and Treatment
article

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

Peter Kaatsch, Daniel Bejarano‐Quisoboni, C. J. Bright, Helena J. H. van der Pal, Claudia E. Kuehni, Gisela Michel, Naïla Aba, Zsuzsanna Jakab, Miranda M Fidler-Benaoudia, Stine Høgsholt, Raoul C. Reulen, Roderick Skinner, Brice Fresneau, Wael Zrafi, Stéphanie Bolle, Giao Vu‐Bezin, Flora E. van Leeuwen, Jop C. Teepen, Monia Zidane, D. Winter, Tuomas Lähteenmäki Taalas, Nadia Haddy, Riccardo Haupt, Lorna Zadravec Zaletel, Carlotta Sacerdote, Charlotte Demoor‐Goldschmidt, Nicolas Waespe, Rodrigue S. Allodji, Monica Terenziani, Milena Maria Maule, Ibrahima Diallo, Julianne Byrne, Edit Bárdi, Jeanette Falck Winther, Thomas Wiebe, Elizabeth A. M. Feijen, Momcilo Jankovic, Cécile M. Ronckers, Damien Llanas, Päivi M. Lähteenmäki, C. Rubino, Desiree Grabow, Francesca Bagnasco, Thibaud Charrier, Helena M. Linge, Claire Ducos, H. Jenkinson, N. Journy, D. Alessi, C. Veres, T. Gudmundsdottir, M. Kaiser, S. Nordenfelt, F. de Vathaire, L. Hjorth, L.C. Kremer, T. Cole, M. Locquet, M.M. Hawkins, W. Gunnes, R. Aho Glele
article en

Abstract

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.

ESMO OpenVol. 11(8)
Semmelweis University (HU), University of Bern (CH), Johannes Kepler University of Linz (AT), Alberta Health Services (CA), Oslo University Hospital (NO), Institut de Radioprotection et de Sûreté Nucléaire (FR), Inserm (FR), University of Lucerne (CH), German Cancer Research Center (DE), Lund University (SE), Université de Versailles Saint-Quentin-en-Yvelines (FR), Heidelberg University (DE), Université Paris-Saclay (FR), Ljubljana University Medical Centre (SI), Istituto Giannina Gaslini (IT), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Institut Gustave Roussy (FR), Turku University Hospital (FI), The Netherlands Cancer Institute (NL), Institute of Oncology Ljubljana (SI), Birmingham Women's Hospital (GB), Birmingham Children's Hospital (GB), Centre de recherche en Epidémiologie et Santé des Populations (FR), Hospital Universitario Quirónsalud Madrid (ES), Kepler Universitätsklinikum (AT), Centre for Research in Early Childhood (GB), University Children’s Hospital Bern (CH), Princess Máxima Center (NL), Cancer Registry of Norway (NO), NHS Digital (GB), Skåne University Hospital (SE), Great North Children's Hospital (GB), Danish Cancer Society (DK), Piedmont Reference Center for Epidemiology and Cancer Prevention (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Icelandic Cancer Society (IS), Fondazione IRCCS Istituto Nazionale dei Tumori (IT), CURE Childhood Cancer (US), Boyne Research Institute (IE), University of Milano-Bicocca (IT), Newcastle University (GB)
Brain Tumour Charity, Ligue Contre le Cancer, Institut National Du Cancer, Fondation Gustave Roussy, FP7 Health
Good health and well-being
Openalex Percentile: Top 9%
Sarcoma Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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