Liu Cheng-Sheng, Tsai Jia-Ruey, Kao Yi-Tzu, Lu Long-Sheng, Chen Yin-Ju, Burnouf Thierry, Wang Peng-Yuan, Chiou Jeng-Fong, Ting Lai-Lei
Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan.
Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Front Oncol. 2021 Feb 11;10:599403. doi: 10.3389/fonc.2020.599403. eCollection 2020.
Vascular leiomyosarcoma is an extremely rare tumor and is associated with poor prognosis among leiomyosarcoma. Surgical resection remains the main treatment option. But outcome of definitive treatment with chemoradiotherapy in inoperable patients is not clear. Here, we report treatment and outcome of definitive chemoradiotherapy in a case of vascular leiomyosarcoma. A 64-year-old man with the initial presentation of pulsatile right neck mass was diagnosed with right carotid body leiomyosarcoma. He refused surgical intervention due to risk of carotid body injury and ischemic stroke. Successful tumor control was achieved with carboplatin-based concurrent chemoradiotherapy. Investigational liquid biopsy for circulating sarcoma cells was also performed to analyze drug sensitivity profile of this rare tumor. One year after treatment, the disease remained well controlled and there was no evidence of baroreflex failure or treatment-related late toxicities. To our best knowledge, this is the first case report of right carotid body leiomyosarcoma controlled with definitive concurrent chemoradiotherapy. The approach of personalized multi-modality treatment will be a focus of our future investigation.
血管平滑肌肉瘤是一种极其罕见的肿瘤，在平滑肌肉瘤中预后较差。手术切除仍然是主要的治疗选择。但对于无法手术的患者，确定性放化疗的治疗效果尚不清楚。在此，我们报告一例血管平滑肌肉瘤患者接受确定性放化疗的治疗情况及结果。一名64岁男性，最初表现为右侧颈部搏动性肿块，被诊断为右侧颈动脉体平滑肌肉瘤。由于存在颈动脉体损伤和缺血性中风的风险，他拒绝了手术干预。基于卡铂的同步放化疗成功实现了肿瘤控制。还进行了循环肉瘤细胞的研究性液体活检，以分析这种罕见肿瘤的药物敏感性特征。治疗一年后，疾病仍得到良好控制，没有压力反射衰竭或治疗相关晚期毒性的证据。据我们所知，这是首例通过确定性同步放化疗控制的右侧颈动脉体平滑肌肉瘤病例报告。个性化多模态治疗方法将是我们未来研究的重点。
