Post irradiation sarcoma of soft tissue and bone.

Thirty-eight patients with sarcomas of soft tissue and bone which followed previous radiotherapy have been treated at the Royal Marsden Hospital between 1951 and 1992. The commonest reasons for initial radiotherapy were carcinoma of the breast and lymphoma, and the median time to development of sarcoma was 11 years. The only long term survivors were those who had complete surgical excision. Seven patients required forequarter amputation (30% of the extremity sarcomas) which reflects their frequent situation in the shoulder girdle and upper arm and the close proximity to the brachial plexus and vascular bundle. The overall prognosis was poor (5-year survival 30%) and probably reflects the poor prognostic factors (size, grade and tumour site) present at the time of diagnosis.