Mark R J, Poen J C, Tran L M, Fu Y S, Juillard G F
Department of Radiation Oncology, Good Samaritan Hospital, Los Angeles, California, USA.
Cancer. 1996 Jun 1;77(11):2400-6. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2400::AID-CNCR32>3.0.CO;2-Z.
Angiosarcomas (AS) are rare, aggressive tumors. Optimal treatment has not been well defined. The authors undertook a retrospective review of patients seen at their institution with the intent of identifying prognostic factors and optimal treatment strategies.
Between 1955 and 1990, 67 patients with AS were seen at the University of California, at Los Angeles Medical Center. Follow-up ranged from 1 to 173 months with a median of 30 months.
The overall prognosis was poor. The actuarial 2- and 5-year disease free survivals (DFS) were 44% and 24%, respectively. Of 52 recurrences after primary treatment, 81% (42 of 52) had a component of local failure. Twenty-eight patients had developed distant metastases at last follow-up. Of patients who received surgery (S) and radiation therapy (RT), with or without chemotherapy (CT), 5-year actuarial DFS was 43%, compared with 17% for patients who underwent S +/- CT as initial treatment (P = 0.03). Only 9% of patients (1 of 11) treated with RT +/- CT were rendered free of disease.
Patients with AS usually present with high grade histology, and with multifocal disease. There is a propensity for both local recurrence and distant metastases. Our results and a review of the literature, suggest that S plus RT offers the best chance for long term control of this aggressive tumor. The role of CT remains undefined.
血管肉瘤（AS）是一种罕见的侵袭性肿瘤。最佳治疗方案尚未明确界定。作者对其机构收治的患者进行了回顾性研究，旨在确定预后因素和最佳治疗策略。
1955年至1990年间，加利福尼亚大学洛杉矶分校医疗中心共收治了67例血管肉瘤患者。随访时间为1至173个月，中位随访时间为30个月。
总体预后较差。2年和5年的无病生存率（DFS）分别为44%和24%。在初次治疗后的52例复发患者中，81%（52例中的42例）存在局部复发。在最后一次随访时，28例患者出现了远处转移。接受手术（S）和放疗（RT）、无论是否接受化疗（CT）的患者，5年预期DFS为43%，而初始治疗采用S±CT的患者为17%（P = 0.03）。仅9%（11例中的1例）接受RT±CT治疗的患者实现了无病生存。
血管肉瘤患者通常表现为高分级组织学特征和多灶性病变。存在局部复发和远处转移的倾向。我们的研究结果以及对文献的回顾表明，手术加放疗为长期控制这种侵袭性肿瘤提供了最佳机会。化疗的作用仍不明确。
