Cutaneous angiosarcoma treated with taxane-based chemoradiotherapy: A multicenter study of 90 Japanese cases.
Cutaneous angiosarcoma treated with taxane-based chemoradiotherapy: A multicenter study of 90 Japanese cases.
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DOI：
10.1002/ski2.180
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发表时间：
2023-02
影响因子：
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通讯作者：
Fujisawa, Yasuhiro
中科院分区：
文献类型：
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作者：
Fujimura, Taku;Furudate, Sadanori;Maekawa, Takeo;Kato, Hiroshi;Ito, Takamichi;Matsushita, Shigeto;Yoshino, Koji;Hashimoto, Akira;Muto, Yusuke;Ohuchi, Kentaro;Amagai, Ryo;Kambayashi, Yumi;Fujisawa, Yasuhiro
皮肤血管肉瘤 (CAS) 很罕见，之前大多数 CAS 研究都是小病例系列，并且 CAS 的随机 II 期研究有限。由于 CAS 的治疗选择存在争议，并且根据高水平证据仅推荐紫杉醇，因此在现实世界实践中评估另一种紫杉烷衍生药物多西紫杉醇的疗效非常重要。在 90 名日本 CAS 患者的维持治疗中，对使用紫杉烷类药物（多西他赛和紫杉醇）进行放化疗的疗效和安全性进行了回顾性检查，其中包括 35 名接受多西他赛治疗的病例和 55 名接受紫杉醇治疗的病例。接受多西紫杉醇治疗的患者组的总生存率和剂量持续时间与紫杉醇治疗组相当，即使在有转移的队列中也是如此。多西紫杉醇和紫杉醇引起的不良事件分别发生在 77.1% 和 69.1% 的病例中。多西紫杉醇治疗组的严重不良事件发生率（40.0%）高于紫杉醇治疗组（23.6%）。周围神经病变仅发生在紫杉醇治疗组中，而重度间质性肺炎仅发生在多西紫杉醇治疗组中。此外，我们还评估了19名选择其他紫杉烷类药物的患者，17名患者选择艾日布林甲酯，11名患者选择帕唑帕尼，2名患者选择纳武单抗作为二线化疗。每月一次的多西他赛方案的疗效相当于通过总生存期和 DDT 评估的每三周一次的紫杉醇方案，即使在有转移的队列中也是如此，并且在日本人群中，它是 CAS 作为维持治疗的一个可耐受的方案。 尽管紫杉醇作为治疗皮肤血管肉瘤（CAS）的标准疗法，但 CAS 的后续治疗有限且仍然存在争议。几种化疗方案被尝试用于 CAS 的治疗。在本报告中，对 90 名日本 CAS 患者进行了回顾性评估，每月多西他赛方案和每三周紫杉醇方案在根治性放疗后的维持环境中的疗效和安全性。我们目前的研究表明，每月一次多西他赛疗法的疗效与通过 OS 和 DDT 评估的每三周一次紫杉醇疗法相当，并且是 CAS 作为维持治疗的可耐受方案。
Cutaneous angiosarcoma (CAS) is rare and most previous studies of CAS have been small case series, and randomized, phase II studies of CAS are limited. Since treatment options for CAS are controversial, and because only paclitaxel should be recommended based on high‐level evidence, it is important to evaluate the efficacy of another taxane‐derived agents, docetaxel, in real‐world practice. The efficacy and safety profiles of chemoradiotherapy using taxane‐based agents, docetaxel and paclitaxel, were retrospectively examined in the maintenance setting in 90 Japanese CAS patients, including 35 docetaxel‐treated cases and 55 paclitaxel‐treated cases. Overall survival and dose duration time of the patient group treated with docetaxel was equivalent to that with paclitaxel, even in the cohorts with metastasis. Adverse events due to docetaxel and paclitaxel were observed in 77.1% and 69.1% of cases, respectively. The incidence ratio of total severe adverse events tended to be higher in the docetaxel‐treated group (40.0%) than in the paclitaxel‐treated group (23.6%). Peripheral neuropathy occurred only in the paclitaxel‐treated group, whereas high‐grade interstitial pneumonia developed only in the docetaxel‐treated group. In addition, we also evaluate 19 patients selected other taxanes, 17 patients selected eribulin methylate, 11 patients pazopanib, and 2 patients selected nivolumab as second‐line chemotherapy. The efficacy of a monthly docetaxel regimen is equivalent to a three‐weekly paclitaxel regimen evaluated by Overall survival and DDT, even in the cohorts with metastasis, and it is a tolerable protocol for CAS as a maintenance therapy in the Japanese population. Although paclitaxel is given as a standard therapy for the treatment of cutaneous angiosarcoma (CAS), subsequent treatment for CAS is limited and still controversial. Several chemotherapy regimens were tentatively used for the treatment of CAS.In this report, the efficacy and safety profiles of monthly docetaxel regimen and a three‐weekly paclitaxel regimen in the maintenance setting after curative radiotherapy were evaluated retrospectively in 90 Japanese CAS patients. Our present study suggested that the efficacy of a monthly docetaxel regimen is equivalent to a three‐weekly paclitaxel regimen evaluated by OS and DDT, and is a tolerable protocol for CAS as a maintenance therapy.