DeMartelaere Sheri L, Roberts Dianna, Burgess Michael A, Morrison William H, Pisters Peter W T, Sturgis Erich M, Ho Viet, Esmaeli Bita
Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Head Neck. 2008 May;30(5):639-46. doi: 10.1002/hed.20757.
Recent isolated case reports have suggested a potential role for neoadjuvant chemotherapy in patients with angiosarcoma. The goal of this report was to investigate the overall treatment outcomes and the neoadjuvant chemotherapy-specific outcomes in patients with cutaneous angiosarcoma of the face with periorbital involvement.
Our tumor database was searched for patients with angiosarcoma and periorbital involvement seen at our institution between 1981 and 2005.
Twenty-one patients were identified,15 of whom had neoadjuvant chemotherapy and 6 of whom had a traditional approach of surgery followed by adjuvant therapy. Fourteen of 15 patients who had neoadjuvant chemotherapy had complete clinical response. Neoadjuvant chemotherapy made definitive surgery unnecessary for 9 patients. The median disease-free interval for the neoadjuvant chemotherapy group was 11.8 months (mean, 38.1 months; range, 2.4-239.6 months). Nine of the 15 patients had recurrences. The time from end of treatment to recurrence ranged from 2.6 to 24.5 months (median, 12.7 months). Five of the 6 patients who had primary surgical resection followed by adjuvant radiotherapy and/or chemotherapy had a complete clinical response, and the median disease-free interval was 31.8 months (mean, 35.9 months; range, 2.7-85 months). Two later developed recurrences, one at 2.7 months and the other at 31.8 months after the end of treatment.
On the basis of this series, the authors conclude that neoadjuvant chemotherapy for periorbital angiosarcoma is a potentially attractive option and in some patients may obviate the need for major surgery, thereby preserving the eye and/or ocular adnexal structures. Given the propensity for recurrence and poor survival, the authors strongly recommend that these patients receive multidisciplinary evaluation and treatment at a major cancer center.
近期的个别病例报告提示新辅助化疗在血管肉瘤患者中可能发挥作用。本报告的目的是研究眼眶周围受累的面部皮肤血管肉瘤患者的总体治疗结果以及新辅助化疗的特定结果。
检索我们机构1981年至2005年间诊治的眼眶周围受累的血管肉瘤患者的肿瘤数据库。
共确定21例患者，其中15例接受新辅助化疗，6例采用传统手术加辅助治疗的方法。15例接受新辅助化疗的患者中有14例获得完全临床缓解。新辅助化疗使9例患者无需进行根治性手术。新辅助化疗组的无病间期中位数为11.8个月（平均38.1个月；范围2.4 - 239.6个月）。15例患者中有9例复发。从治疗结束到复发的时间为2.6至24.5个月（中位数12.7个月）。6例接受初次手术切除后辅助放疗和/或化疗的患者中有5例获得完全临床缓解，无病间期中位数为31.8个月（平均35.9个月；范围2.7 - 85个月）。2例后来复发，1例在治疗结束后2.7个月复发，另1例在31.8个月复发。
基于本系列研究，作者得出结论，眼眶周围血管肉瘤的新辅助化疗是一个潜在有吸引力的选择，在一些患者中可能无需进行大手术，从而保留眼球和/或眼附属器结构。鉴于复发倾向和较差的生存率，作者强烈建议这些患者在大型癌症中心接受多学科评估和治疗。
