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Clinical outcomes following high-dose-rate surface applicator brachytherapy for angiosarcoma of scalp and face
Journal of Contemporary Brachytherapy ( IF 1.4 ) Pub Date : 2021-04-14 , DOI: 10.5114/jcb.2021.105285 Devarati Mitra 1, 2 , Phillip M Devlin 1 , Ivan Buzurovic 1 , Katherine Thornton 3 , Allen C Lam 4 , Chandrajit P Raut 5, 6 , Elizabeth H Baldini 1, 5 , Miranda B Lam 1, 5
Journal of Contemporary Brachytherapy ( IF 1.4 ) Pub Date : 2021-04-14 , DOI: 10.5114/jcb.2021.105285 Devarati Mitra 1, 2 , Phillip M Devlin 1 , Ivan Buzurovic 1 , Katherine Thornton 3 , Allen C Lam 4 , Chandrajit P Raut 5, 6 , Elizabeth H Baldini 1, 5 , Miranda B Lam 1, 5
Affiliation
Introduction
Angiosarcoma is a sub-type of soft tissue sarcoma, often presenting as a multifocal or diffuse disease process with poor prognosis. This study presents outcomes of a single institution cohort of patients with angiosarcoma of the scalp and face following treatment with multimodality therapy, including high-dose-rate surface applicator (HDR-SA) brachytherapy, and represents the largest cohort utilizing this therapeutic approach.
Material and methods
Twenty patients with primary or recurrent angiosarcoma of the face or scalp were treated with HDR-SA brachytherapy between 2003-2018, with clinical characteristics and outcomes collected from medical records and used to identify prognostic features.
Results
Median follow-up was 45 months. Patients treated with HDR-SA brachytherapy had a 4-year local control rate of 63%, a 4-year progression-free survival (PFS) rate of 20%, and a 4-year overall survival rate of 54%. Disease features associated with worse loco-regional control (LRC) included location on the scalp (vs. face, p = 0.04) and tumor size ≥ 5 cm (p = 0.0099). Outcomes after HDR-SA brachytherapy for salvage therapy vs. HDR-SA brachytherapy as a component of an initial treatment approach were also significantly different, with worse LRC (p = 0.0084) and worse overall survival (OS) (p = 0.0019) in a setting of salvage therapy.
Conclusions
Local control rates following HDR-SA brachytherapy for scalp or face angiosarcoma are moderate and similar to what is described in the literature using a variety of local control treatment modalities. Smaller tumors and those involving the face rather than scalp had better outcomes. PFS rates were poor and there is a pressing need for treatment intensification and novel therapeutic options.
中文翻译：
高剂量率表面涂药器近距离放射治疗头皮和面部血管肉瘤的临床结果
介绍
血管肉瘤是软组织肉瘤的一种亚型，通常表现为多灶性或弥漫性疾病过程，预后不良。本研究展示了头皮和面部血管肉瘤患者在接受包括高剂量率表面涂药器 (HDR-SA) 近距离放射治疗在内的多模式治疗后的单一机构队列的结果，并代表了使用这种治疗方法的最大队列。
材料和方法
2003-2018 年间，20 名面部或头皮原发性或复发性血管肉瘤患者接受了 HDR-SA 近距离放射治疗，其临床特征和结果从医疗记录中收集并用于确定预后特征。
结果
中位随访时间为 45 个月。接受 HDR-SA 近距离放射治疗的患者 4 年局部控制率为 63%，4 年无进展生存 (PFS) 率为 20%，4 年总生存率为 54%。与较差的局部区域控制 (LRC) 相关的疾病特征包括头皮位置（相对于面部，p = 0.04）和肿瘤大小 ≥ 5 cm（p = 0.0099）。用于挽救治疗的 HDR-SA 近距离放射治疗与作为初始治疗方法组成部分的 HDR-SA 近距离放射治疗后的结果也有显着差异，LRC 更差 (p = 0.0084) 和总生存期 (OS) 更差 (p = 0.0019)抢救治疗的设置。
结论
对头皮或面部血管肉瘤进行 HDR-SA 近距离治疗后的局部控制率适中，与使用各种局部控制治疗方式的文献中描述的相似。较小的肿瘤和涉及面部而不是头皮的肿瘤具有更好的结果。PFS 率很低，迫切需要强化治疗和新的治疗选择。
更新日期：2021-04-15
Angiosarcoma is a sub-type of soft tissue sarcoma, often presenting as a multifocal or diffuse disease process with poor prognosis. This study presents outcomes of a single institution cohort of patients with angiosarcoma of the scalp and face following treatment with multimodality therapy, including high-dose-rate surface applicator (HDR-SA) brachytherapy, and represents the largest cohort utilizing this therapeutic approach.
Material and methods
Twenty patients with primary or recurrent angiosarcoma of the face or scalp were treated with HDR-SA brachytherapy between 2003-2018, with clinical characteristics and outcomes collected from medical records and used to identify prognostic features.
Results
Median follow-up was 45 months. Patients treated with HDR-SA brachytherapy had a 4-year local control rate of 63%, a 4-year progression-free survival (PFS) rate of 20%, and a 4-year overall survival rate of 54%. Disease features associated with worse loco-regional control (LRC) included location on the scalp (vs. face, p = 0.04) and tumor size ≥ 5 cm (p = 0.0099). Outcomes after HDR-SA brachytherapy for salvage therapy vs. HDR-SA brachytherapy as a component of an initial treatment approach were also significantly different, with worse LRC (p = 0.0084) and worse overall survival (OS) (p = 0.0019) in a setting of salvage therapy.
Conclusions
Local control rates following HDR-SA brachytherapy for scalp or face angiosarcoma are moderate and similar to what is described in the literature using a variety of local control treatment modalities. Smaller tumors and those involving the face rather than scalp had better outcomes. PFS rates were poor and there is a pressing need for treatment intensification and novel therapeutic options.
中文翻译：
高剂量率表面涂药器近距离放射治疗头皮和面部血管肉瘤的临床结果
介绍
血管肉瘤是软组织肉瘤的一种亚型，通常表现为多灶性或弥漫性疾病过程，预后不良。本研究展示了头皮和面部血管肉瘤患者在接受包括高剂量率表面涂药器 (HDR-SA) 近距离放射治疗在内的多模式治疗后的单一机构队列的结果，并代表了使用这种治疗方法的最大队列。
材料和方法
2003-2018 年间，20 名面部或头皮原发性或复发性血管肉瘤患者接受了 HDR-SA 近距离放射治疗，其临床特征和结果从医疗记录中收集并用于确定预后特征。
结果
中位随访时间为 45 个月。接受 HDR-SA 近距离放射治疗的患者 4 年局部控制率为 63%，4 年无进展生存 (PFS) 率为 20%，4 年总生存率为 54%。与较差的局部区域控制 (LRC) 相关的疾病特征包括头皮位置（相对于面部，p = 0.04）和肿瘤大小 ≥ 5 cm（p = 0.0099）。用于挽救治疗的 HDR-SA 近距离放射治疗与作为初始治疗方法组成部分的 HDR-SA 近距离放射治疗后的结果也有显着差异，LRC 更差 (p = 0.0084) 和总生存期 (OS) 更差 (p = 0.0019)抢救治疗的设置。
结论
对头皮或面部血管肉瘤进行 HDR-SA 近距离治疗后的局部控制率适中，与使用各种局部控制治疗方式的文献中描述的相似。较小的肿瘤和涉及面部而不是头皮的肿瘤具有更好的结果。PFS 率很低，迫切需要强化治疗和新的治疗选择。
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