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头面部皮肤血管肉瘤:日本43例患者治疗结果的单中心分析

Cutaneous angiosarcoma of the head and face: a single-center analysis of treatment outcomes in 43 patients in Japan.

作者信息

Ito Takamichi, Uchi Hiroshi, Nakahara Takeshi, Tsuji Gaku, Oda Yoshinao, Hagihara Akihito, Furue Masutaka

机构信息

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.

出版信息

J Cancer Res Clin Oncol. 2016 Jun;142(6):1387-94. doi: 10.1007/s00432-016-2151-2. Epub 2016 Mar 25.

Abstract

PURPOSE

For a better understanding of angiosarcoma, we summarized our 30-year experience of conventional treatment outcomes before the era of molecular-targeted therapy.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Our results suggest that continued chemotherapy with taxanes is important for patient survival.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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