Angiosarcoma successfully treated with HART
MedWire News: Hyperfractionated and accelerated radiotherapy (HART) produces a very high rate of local disease control, disease-free survival, and overall survival in women who develop post-breast-conserving therapy (BCT) angiosarcoma, US researchers report.
“With BCT as the standard of care for patients with noninvasive and early stage invasive breast cancer, a small incidence of post-BCT angiosarcoma has emerged,” explain Nancy Mendenhall and co-workers from the University of Florida College of Medicine in Gainsville.
The majority of therapeutic interventions have been unsuccessful and there appears to be no consensus in the medical literature to date regarding the treatment of this malignancy, say the researchers.
In the present study, Mendenhall and team assessed the long-term outcomes of a novel approach using HART for angiosarcoma after BCT. In total, 14 patients with angiosarcoma were treated with HART with or without surgery at the University of Florida between 1997 and 2006. All patients were originally diagnosed with in situ or early stage, lymph node-negative breast cancer.
The researchers report that, at the time of last follow-up, nine patients had remained continuously disease free for a median of 5 years after HART. Furthermore, two patients were alive and well more than 9 years after treatment.
Five patients had further manifestations of angiosarcoma after HART at a median of 1 month: three with progressive pulmonary and/or mediastinal disease that was likely present before HART, and two with local or regional disease extension.
The progression-free survival rate for all patients was 71% at 2 years and 64% at 5 years. The overall and cause-specific survival rates were both 86% at 2 years and 5 years.
“To the best of [our] knowledge, HART with or without subsequent surgery, as documented in the current series, is the first approach to provide a high rate of local control, disease-free survival, and overall survival after the development of post-BCT angiosarcoma,” conclude Mendenhall et al in the journal Cancer.
The authors believe the success noted with this treatment regimen is related to both the hyperfractionation and acceleration of the radiotherapy dose delivered.
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By Laura Dean