Radiation-induced sarcomas of the head and neck

Table 1 Summary of key findings

With improved oncologic outcomes, RIS are increasingly seen in long-term survivors of head and neck cancers

There is no subsite predilection; They can arise in any irradiated tissue of mesenchymal origin

Common histologic subtypes parallel their de novo counterparts

Imaging features of RIS are not pathognomonic but large size, extensive local invasion with bony destruction, and marked enhancement within a prior radiotherapy field are suggestive of a diagnosis of RIS

RIS development may be influenced by factors such as radiation dose, age at initial exposure, exposure to chemotherapeutic agents, and genetic tendency

Precise pathogenetic mechanisms of RIS are poorly understood

Management is challenging, entailing surgery in irradiated tissue and limited scope for further radiotherapy and chemotherapy

RIS is associated with significantly poorer outcomes than stage-matched de novo sarcomas

Surgical resection with clear margins appears to offer the best chance for cure

RIS: Radiation-induced sarcomas.