Purpose/Objective: Cutaneous angiosarcoma is a rare and highly aggressive vascular tumor, comprising less than 0.1% of head and neck malignancies. The aim of this study was to analyze the treatment outcomes of patients who received definitive hypofractionated high-dose electron beam radiotherapy (RT) for angiosarcoma of the scalp.Materials/Methods: Between 2008 and 2012, 9 patients with histologically proven angiosarcoma of the scalp visited the Department of Radiation Oncology of our institution for RT. All tumors were over 10 cm in diameter and unresectable. The median age was 80 years (range: 73-92). One patient rejected all radical treatments, and the other 8 patients were treated by RT with curative intent with chemotherapy or interleukin-2 immunotherapy. In this study, those 8 patients were analyzed. We used 6-12-MeV electron beams with or without a bolus, and the energy level was selected depending on the depth of disease measured by CT or MRI. The total dose was 63-75 Gy (median: 70 Gy) in 26-30 fractions, and the fraction size was 2.5 Gy in principle. Six of the 8 patients were given 70 Gy in 28 fractions or more. Overall survival (OS) and distant metastasis-free survival (DMFS) rates of the 8 patients treated by RT were calculated from the date of diagnosis. Toxicities following RT were graded using the Common Toxicity Criteria for Adverse Events v.4.0.Results: For all 8 patients treated by RT, the median follow-up was 20.8 months (range: 5.5-66.5). That of survivors was 28.0 months (range: 13.6-66.5). Four patients died from distant metastases. For all 8 patients, the median OS was 20.8 months (range: 5.5-66.5). Only 1 patient suffered local relapse, at 26.3 months, and the complete response rate was 87.5%. DM occurred in 7 patients, at a median of 9.6 months (1-y DMFS: 50%; 2-y DMFS: 25%). The lung was the most common site of DM (n = 3). The other sites of DM were the liver, brain, bone, cervical lymph, and the skin (n = 1). Acute dermatitis was grade 2 in 2 patients (25%) and grade 3 in 6 (75%). All cases of dermatitis improved within a few months. No patient developed grade 4 or higher adverse events.Conclusions: Hypofractionated high-dose RT with electron beams was feasible and achieved excellent local control of angiosarcoma in older patients.
Katayama, E,
Feasibility and Efficacy of Definitive Hypofractionated High-dose Electron Beam Radiotherapy for Cutaneous Angiosarcoma of the Scalp. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/14042988.html
