Amit Roy a , 1 , Prashant Gabani b , 1 , Elizabeth J. Davis c , Peter Oppelt d , Emily Merfeld e , Vicky L. Keedy c , Imran Zoberi a , John S.A. Chrisinger f , Jeff M. Michalski a , Brian Van Tine d , Matthew B. Spraker a , *
28 January 2021
CRT, paclitaxel-based chemoradiation, Non-CRT, other modalities, RT, radiotherapy, LC, local control, DC, distant control, PFS, progression-free survival, OS, overall survival, Angiosarcoma, Radiation therapy, Chemotherapy, Paclitaxel, Concurrent chemoradiation
Cutaneous angiosarcoma has poor outcomes with no standardized treatment regimen.
Paclitaxel-based chemoRT (CRT) was compared to other therapies at two US institutions.
Similar oncologic outcomes and improved survival with paclitaxel CRT.
Paclitaxel CRT + surgery provided best oncologic outcomes and survival.
Paclitaxel CRT + surgery regimen now being studied in a prospective phase II trial.
We compared clinical outcomes in patients with cutaneous angiosarcoma receiving concurrent paclitaxel-based chemoradiotherapy (CRT) vs. other modalities (Non-CRT).
Patients with non-metastatic cutaneous angiosarcoma diagnosed from 1998 to 2018 at two institutions were identified. In the CRT cohort, paclitaxel 80 mg/m 2 weekly was given for up to 12 weeks and patients received radiotherapy (RT) during the final 6 weeks of chemotherapy. The RT dose was 50–50.4 Gy delivered in 1.8–2 Gy per fraction with an optional post-operative boost of 10–16 Gy. Kaplan-Meier and log-rank statistics were used to compare the outcomes between the two groups. P < 0.05 was considered statistically significant.
Fifty-seven patients were included: 22 CRT and 35 Non-CRT. The CRT cohort had more patients > 60 years (100% vs. 60%, p < 0.001) and tumors >5 cm (68.2% vs 54.3%, p = 0.023). The median follow-up was 25.8 (1.5–155.2) months. There was no significant difference in 2-year local control (LC), distant control (DC), or progression-free survival (PFS) between the two groups. The 2-year overall survival (OS) was significantly higher for the CRT cohort (94.1% vs. 71.6%, p = 0.033). Amongst the subset of patients in the CRT cohort who received trimodality therapy, the 2-year LC, DC, PFS, and OS was 68.6%, 100%, 68.6%, and 100%, respectively.