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, and 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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