Abstract
Cutaneous angiosarcomas is a rare cancer with poor prognoses. The common radiotherapy techniques that have been reported so far are two pairs of lateral X-ray and electron fields. However, it is quite difficult to irradiate scalp angiosarcomas (SAs) homogeneously with this technique. In this study, safety, effectiveness, and risk factors were assessed for localized SAs ≥ 5 cm treated with intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) with boluses. Sixty-eight angiosarcoma patients who had received radiotherapy in our institution between January 2007 and November 2020 were retrieved from our radiotherapy database. Of these patients, 27 localized SA patients were included in the retrospective analysis. The 2-year overall survival, local progression-free rate, and distant metastases-free survival were 41.8%, 48.4%, and 33.1%. All the patients experienced acute radiation dermatitis ≥ grade 2, with18 (66.7%) ≥ grade 3. No nodule lesion was a significant unfavorable predictive factor of acute radiation dermatitis ≥ grade 3. Tumor bleeding at the initiation of radiotherapy and tumor invasion to the face were significant predictive factors of overall survival, and tumor bleeding at the initiation of radiotherapy was also a significant predictive factor of local progression-free rate.
Highlights
Cutaneous angiosarcomas is a rare cancer with poor prognoses
In Bernstein et al.[18], intensitymodulated radiotherapy (IMRT) was used for 21 patients; there were a few patients in that study who received definitive radiotherapy without surgery, and the remaining patients were treated with surgery alone or surgery with postoperative radiation therapy (RT)
Two patients were treated with a combination of electron beams and X-rays: one received irradiation using electron beams to the area around the eyes with lead contact lenses, and in the other patient, electron beams were used to initiate RT as soon as possible
Summary
Cutaneous angiosarcomas is a rare cancer with poor prognoses. The common radiotherapy techniques that have been reported so far are two pairs of lateral X-ray and electron fields. Safety, effectiveness, and risk factors were assessed for localized SAs ≥ 5 cm treated with intensitymodulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) with boluses. Sixtyeight angiosarcoma patients who had received radiotherapy in our institution between January 2007 and November 2020 were retrieved from our radiotherapy database Of these patients, 27 localized SA patients were included in the retrospective analysis. The most common RT technique that has been reported so far for scalp angiosarcomas is the conventional method of combining two pairs of lateral X-ray and electron fields[10–12]. There are few reports of the scalp angiosarcoma patients treated with IMRT or VMAT without surgery. We retrospectively investigated the safety and effectiveness of definitive RT with IMRT or VMAT for localized scalp angiosarcomas ≥ 5 cm by excluding patients who received postoperative RT
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