Angiosarcoma treated with radiotherapy: impact of tumor type and size on outcome.

Abstract

PURPOSE:

Angiosarcoma is a rare and highly malignant vascular neoplasm. The purpose of this study was to elucidate the tumor characteristics and evaluate the efficacy of radiotherapy (RT) for angiosarcoma.

MATERIALS AND METHODS:

Thirty patients with angiosarcoma (20 males and 10 females, age range 4-89 years, median 66) who received RT from 1986 to 1999 were enrolled in the study. Twenty-four patients had angiosarcoma of the face and scalp (AFS), and 6 patients had angiosarcomas at other sites. AFS was classified into two categories (according to the macroscopic features): nodular AFS (14 patients) and endophytic AFS (10 patients). The median prescribed irradiation dose was 68 Gy. Surgery had been previously performed in 9 patients, and adjuvant immunotherapy using recombinant interleukin-2 (rIL-2) was combined during and after RT in 20 patients. Univariate analyses and calculation of survival by Kaplan-Meier methods were performed.

RESULTS:

Local tumor control was obtained in 17 patients (57%). However, 7 (47%) of them developed distant metastases. The median survival time for all patients was 8 months (7 months for AFS), and the 13-year overall survival rate was 25% (20% for AFS). Twenty-one patients died of angiosarcoma, with the cause of death local failure in 7 patients, distant failure in 7, and both in 7. Tumor type and size were found to be significant prognostic factors (p = 0.004 and p = 0.007, respectively), and age, total amount of rIL-2, gender, radiation dose, and surgery were not. Six patients (4 with nodular AFS and 2 with angiosarcoma in other parts) survived >2 years. No patient with endophytic AFS survived >2 years. Ten patients (33%) died of respiratory failure secondary to pulmonary metastases. High-dose rIL-2 administration suppressed the occurrence of distant metastases (p = 0.006). Two patients developed radiation dermatitis (Radiation Therapy Oncology Group Grade 4).

CONCLUSION:

RT, combined with complete resection or adjuvant rIL-2 immunotherapy, could be a promising treatment strategy, leading to prolonged survival in patients with angiosarcoma.

• Authors: Ryohei Sasaki, Toshinori Soejima, Kazushi Kishi, Yoshinari Imajo, Saeko Hirota, Norihiko Kamikonya, Masao Murakami, Tetsuya Kawabe, Yasuo Ejima, Akira Matsumoto, Kazuo Sugimura
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 52 Issue 4 Pg. 1032-40 (Mar 15 2002) ISSN: 0360-3016 [Print] United States
• PMID: 11958899 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Interleukin-2
• Recombinant Proteins

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Bone Neoplasms (mortality, pathology, radiotherapy, surgery)
• Cause of Death
• Child
• Child, Preschool
• Combined Modality Therapy
• Facial Neoplasms (mortality, pathology, radiotherapy, surgery)
• Female
• Hemangiosarcoma (mortality, pathology, radiotherapy, surgery)
• Humans
• Interleukin-2 (therapeutic use)
• Lung Neoplasms (secondary)
• Male
• Middle Aged
• Prognosis
• Radiodermatitis (etiology)
• Radiotherapy Dosage
• Recombinant Proteins (therapeutic use)
• Retrospective Studies
• Scalp (pathology, surgery)