Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review.

Autor: Depla AL; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands., Scharloo-Karels CH; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands., de Jong MAA; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands., Oldenborg S; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands., Kolff MW; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands., Oei SB; Department of Radiation Oncology and Hyperthermia, Institute Verbeeten, Tilburg, The Netherlands., van Coevorden F; Department of Surgery, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Rhoon GC; Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC-Cancer Institute, Rotterdam, The Netherlands., Baartman EA; Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC-Cancer Institute, Rotterdam, The Netherlands., Scholten RJ; Dutch Cochrane Center, Utrecht, The Netherlands., Crezee J; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands., van Tienhoven G; Academic Medical Center, Department of Radiation Oncology and Hyperthermia, Amsterdam, The Netherlands. Electronic address: g.vantienhoven@amc.uva.nl.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2014 Jul; Vol. 50 (10), pp. 1779-1788. Date of Electronic Publication: 2014 Apr 11.
DOI: 10.1016/j.ejca.2014.03.002
Abstrakt: Background: Radiation-associated angiosarcoma (RAAS) of the breast is a rare, aggressive disease. The incidence is increasing with the prolonged survival of women irradiated for primary breast cancer. Surgery is the current treatment of choice. Prognosis is poor. This review aims to evaluate all publications on primary treatment of RAAS to identify prognostic factors and evaluate treatment modalities.
Methods: Databases were searched for articles with published individual patient data on prognostic factors, treatment and follow-up of patients with RAAS. A regression analysis was performed to test the prognostic values of age, interval between primary treatment and RAAS, tumour size and grade on the local recurrence-free interval (LRFI) and overall survival (OS). The effects of treatment modalities surgery, radiation (with or without hyperthermia) and chemotherapy or combinations were evaluated.
Results: 74 articles were included, representing data on 222 patients. In these patients, the 5-year OS was 43% and 5-year LRFI was 32%. Tumour size and age were significant prognostic factors on LRFI and OS. Of all patients, 68% received surgery alone, 17% surgery and reirradiation and 6% surgery with chemotherapy. The remaining 9% received primary treatments without surgery. Surgery with radiotherapy had a better 5-year LRFI of 57% compared to 34% for surgery alone (p=0.008). The value of other treatment modalities could not be assessed.
Conclusions: This systematic review confirms the poor prognosis of RAAS. Tumour size and age were of prognostic value. The addition of reirradiation to surgery in the treatment of RAAS appears to enhance local control.
(Copyright © 2014 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: