Chemoradiotherapy with taxane is superior to conventional surgery and radiotherapy in the management of cutaneous angiosarcoma: a multicentre, retrospective study. (10th November 2014)

• Record Type: Journal Article
• Authors: Fujisawa, Y.; Yoshino, K.; Kadono, T.; Miyagawa, T.; Nakamura, Y.; Fujimoto, M.
• Is Part Of: British journal of dermatology. Volume 171:Number 6(2014:Dec.)
• Page Start: 1493
• Page End: 1500
• Publication Date: 2014-11-10
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.13110
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" id="bjd13110-abs-0001"> <title>Summary</title> <sec id="bjd13110-sec-0001" sec-type="section"> <title>Background</title> <p>The prognosis of cutaneous angiosarcoma (CAS), especially for patients with tumours > 5 cm has been reported to be dismal, even after conventional surgery and radiotherapy (S + RT).</p> </sec> <sec id="bjd13110-sec-0002" sec-type="section"> <title>Objectives</title> <p>To demonstrate the efficacy of chemoradiotherapy with taxane (T + RT) and maintenance chemotherapy.</p> </sec> <sec id="bjd13110-sec-0003" sec-type="section"> <title>Methods</title> <p>We retrospectively reviewed 16 patients with CAS treated with T + RT and 12 patients treated with S + RT. None had distant metastasis. Tumour sites included the scalp (<italic>n </italic>=<italic> </italic>25) and limbs (<italic>n </italic>=<italic> </italic>3). The chemotherapy regimens used in T + RT were monthly docetaxel (<italic>n </italic>=<italic> </italic>10), biweekly docetaxel (<italic>n </italic>=<italic> </italic>1), weekly docetaxel (<italic>n </italic>=<italic> </italic>5) and weekly paclitaxel (<italic>n </italic>=<italic> </italic>1). The median radiation dose was 70 Gy. Nine patients receiving T + RT continued chemotherapy as maintenance therapy (monthly docetaxel in nine patients and monthly paclitaxel in two patients) and four patients receiving S + RT received adjuvant chemotherapy (weekly docetaxel).</p> </sec> <sec id="bjd13110-sec-0004" sec-type="section"> <title>Results</title> <p>The response ratio of T + RT was 94% (14 complete remission and one partial remission). The 5‐year overall survival (OS) rate of patients receiving T + RT was statistically higher than those receiving conventional S + RT (56% and 8%, respectively; <italic>P </italic><<italic> </italic>0·01). Moreover, patients who received T + RT with maintenance chemotherapy showed a significant improvement in OS than those receiving T + RT alone (<italic>P </italic><<italic> </italic>0·01). There was a strong trend for relapse‐free survival, but it was not significant (<italic>P </italic>=<italic> </italic>0·07). These data indicate that maintenance chemotherapy is crucial for long‐term survival after T + RT.</p> </sec> <sec id="bjd13110-sec-0005" sec-type="section"> <title>Conclusions</title> <p>From these results, we suggest that T + RT followed by maintenance chemotherapy is a plausible method for managing CAS, especially large tumours that are difficult to manage with S + RT alone.</p> </sec> </abstract>