Risk of Radiation-Related Subsequent Malignant Tumors in Survivors of Ewing's Sarcoma2

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Abstract
Long-term survivors of Ewing''s sarcoma (24) were identified as being at risk for a 2nd primary tumor. Among this group of patients followed from 3-22 yr, 4 new bone tumors were observed, whereas 1.2 .times. 10-3 were expected. All new tumors arose in heavily irradiated areas. The risk associated with radiation after 3 yr was 7.2 cases/million person-yr per rad. The cumulative cancer risk over 10 yr for irradiated patients was 35% (SE, 15.1%). Intensive chemotherapy (cyclophosphamide and vincristine administered in 5 or more courses) seemed to exert an enhancing effect, increasing the rate of development of new tumors.

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