Radiation-Associated Angiosarcoma

• Radiation-associated angiosarcoma:
  • Is a rare complication from prior radiation
  • The average time from radiation to presentation:
    • Is 10 years
  • The mainstay of treatment remains:
    • Surgical excision with negative margins:
      • However, local recurrence and distant recurrence remains quite high:
        • Close monitoring is recommended
• The role of chemotherapy:
  • Is unclear
    • Therefore, surgery should remain the primary treatment of choice
• Preoperative radiation:
  • With hyperfractionated and accelerated radiation therapy:
    • Has also been identified as a potential alternative to surgery alone, with improved survival and should be considered:
      • More trials are needed to improve outcomes for this aggressive but rare complication of radiation
• References
  • Torres, K.E., Ravi, V., Kin, K. et al. Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer. Ann Surg Oncol. 2013;20(4):1267-1274.
  • Palta M , Morris CG, Grobmyer SR, Copeland EM, Mendenhall NP. (2010), Angiosarcoma after breast‐conserving therapy. Cancer. 116(8):1872-1878.
  • Smith TL, Morris CG, Mendenhall NP. Angiosarcoma after breast-conserving therapy: long-term disease control and late effects with hyperfractionated accelerated re-irradiation (HART). Acta Oncol. 2014;53(2):235-241.
  • Penel N, Bui BN, Bay JO, et al. Phase II trial of weekly paclitaxel for unresectable angiosarcoma: the ANGIOTAX Study. J Clin Oncol. 2008;26(32):5269-5274.
  • Palta M, Morris CG, Grobmyer SR, Copeland EM 3rd, Mendenhall NP. Angiosarcoma after breast-conserving therapy: long-term outcomes with hyperfractionated radiotherapy. Cancer. 2010;116(8):1872-1878.

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