Ito Takamichi, Uchi Hiroshi, Nakahara Takeshi, Tsuji Gaku, Oda Yoshinao, Hagihara Akihito, Furue Masutaka
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Cancer Res Clin Oncol. 2016 Jun;142(6):1387-94. doi: 10.1007/s00432-016-2151-2. Epub 2016 Mar 25.
For a better understanding of angiosarcoma, we summarized our 30-year experience of conventional treatment outcomes before the era of molecular-targeted therapy.
We conducted a retrospective review of our 43 patients with cutaneous angiosarcoma of the head and face, and investigated the prognostic factors including the treatment strategy. Disease-specific survival (DSS) and event-free survival (EFS) were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazard regression model.
All patients were Japanese (25 males and 18 females), with a mean age of 72.1. For the initial treatment of the primary lesion, 34 patients underwent radiotherapy with or without taxanes (docetaxel and/or paclitaxel); only 6 patients underwent surgical excision. As the systemic adjuvant therapy, 19 patients were treated with taxanes and 15 with interleukin-2. Interestingly, patients who underwent the continued chemotherapy with taxanes had significantly prolonged DSS (5-year DSS, 57.0 vs. 19.6 %; median survival, 62.2 vs. 17.7 months; P = 0.0049) and EFS (5-year EFS, 34.9 vs. 5.6 %; median survival, 46.7 vs. 12.4 months; P = 0.0024) than the others. The continuous use of taxanes was also a prognostic factor in multivariate analyses. Neither radiotherapy nor surgical excision significantly influenced the patients' outcome. Among five patients who survived more than 5 years, three underwent surgical excision of the primary tumor or lung metastasis.
Our results suggest that continued chemotherapy with taxanes is important for patient survival.
为了更好地了解血管肉瘤，我们总结了在分子靶向治疗时代之前30年常规治疗结果的经验。
我们对43例头面部皮肤血管肉瘤患者进行了回顾性研究，并调查了包括治疗策略在内的预后因素。采用Kaplan-Meier方法估计疾病特异性生存率（DSS）和无事件生存率（EFS），并使用Cox比例风险回归模型进行多变量分析。
所有患者均为日本人（男性25例，女性18例），平均年龄72.1岁。对于原发性病变的初始治疗，34例患者接受了放疗，联合或不联合紫杉烷类药物（多西他赛和/或紫杉醇）；只有6例患者接受了手术切除。作为全身辅助治疗，19例患者接受了紫杉烷类药物治疗，15例接受了白细胞介素-2治疗。有趣的是，接受持续紫杉烷类化疗的患者的DSS（5年DSS，57.0%对19.6%；中位生存期，62.2个月对17.7个月；P = 0.0049）和EFS（5年EFS，34.9%对5.6%；中位生存期，46.7个月对12.4个月；P = 0.0024）明显长于其他患者。在多变量分析中，持续使用紫杉烷类药物也是一个预后因素。放疗和手术切除均未对患者的预后产生显著影响。在5例存活超过5年的患者中，3例接受了原发性肿瘤或肺转移的手术切除。
我们的结果表明，持续使用紫杉烷类化疗对患者生存至关重要。
