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头皮血管肉瘤无颈部淋巴结转移的放射治疗单机构经验:使用紫杉烷进行同步放化疗并维持化疗对患者预后的影响。

Single institutional experience of radiation therapy for angiosarcoma of the scalp without cervical lymph node metastases: Impact of concurrent chemoradiation with maintenance chemotherapy using taxanes on patient prognosis.

作者信息

Ihara Hiroki, Kaji Tatsuya, Katsui Kuniaki, Miyake Tomoko, Waki Takahiro, Katayama Norihisa, Matsuzaki Hidenobu, Yamasaki Osamu, Kuroda Masahiro, Morizane Shin, Kanazawa Susumu

机构信息

Department of Radiology, Tsuyama Chuo Hospital, Okayama 708-0841, Japan.

Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.

出版信息

Mol Clin Oncol. 2019 Nov;11(5):498-504. doi: 10.3892/mco.2019.1918. Epub 2019 Sep 5.

Abstract

Cutaneous angiosarcoma is a rare aggressive malignant tumor. Concurrent chemoradiation (CCRT) with maintenance chemotherapy using taxanes is one of the primary treatments. The aim of the present study was to retrospectively analyze the efficacy of CCRT with maintenance chemotherapy using taxanes in localized angiosarcoma of the scalp without cervical lymph node metastases. A total of 19 patients treated with radiation therapy for localized angiosarcomas of the scalp without cervical lymph node metastases were enrolled. The overall survival (OS), progression-free survival (PFS), and local control (LC) rates were calculated using Kaplan-Meier analysis. Univariate analyses were performed for various potential prognostic factors for OS, PFS, and LC. The median radiation dose was 70 Gy (range, 60-70 Gy), and the fractional dose was 2 Gy. Radiation therapy alone, radiation therapy + interleukin-2, surgery + CCRT with maintenance chemotherapy, CCRT with maintenance chemotherapy, and CCRT without maintenance chemotherapy were administered to 2, 4, 2, 9 and 2 patients, respectively. The 1- and 3-year OS, PFS, and LC rates were 88 and 52%, 47 and 33%, and 74 and 56%, respectively. CCRT with maintenance chemotherapy and surgery were significant prognostic factors for PFS (P=0.036 and 0.025, respectively). Therefore, CCRT with maintenance chemotherapy using taxanes might be effective in treating localized angiosarcomas of the scalp without cervical lymph node metastases.

摘要

皮肤血管肉瘤是一种罕见的侵袭性恶性肿瘤。采用紫杉烷进行维持化疗的同步放化疗(CCRT)是主要治疗方法之一。本研究的目的是回顾性分析采用紫杉烷进行维持化疗的CCRT对无颈部淋巴结转移的头皮局限性血管肉瘤的疗效。共纳入19例接受放疗的无颈部淋巴结转移的头皮局限性血管肉瘤患者。采用Kaplan-Meier分析计算总生存期(OS)、无进展生存期(PFS)和局部控制(LC)率。对OS、PFS和LC的各种潜在预后因素进行单因素分析。中位放疗剂量为70 Gy(范围60 - 70 Gy),分次剂量为2 Gy。分别有2、4、2、9和2例患者接受单纯放疗、放疗 + 白细胞介素 - 2、手术 + 采用维持化疗的CCRT、采用维持化疗的CCRT以及不采用维持化疗的CCRT。1年和3年的OS、PFS和LC率分别为88%和52%、47%和33%、74%和56%。采用维持化疗的CCRT和手术是PFS的显著预后因素(分别为P = 0.036和0.025)。因此,采用紫杉烷进行维持化疗的CCRT可能对治疗无颈部淋巴结转移的头皮局限性血管肉瘤有效。

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