Angiosarcoma of the scalp treated with curative radiotherapy plus recombinant interleukin-2 immunotherapy.
OBJECTIVE
To evaluate the effectiveness of curative radiotherapy (RT) plus recombinant interleukin-2 (rIL-2) immunotherapy regarding the treatment results for angiosarcoma of the scalp. Curative resection of angiosarcoma of the scalp is usually difficult because of the diffuse, clinically undetectable local spread. RT is a rational therapeutic approach, because a wide region of the dermis can be treated, while sparing the underlying normal tissues. Recently, the effectiveness of immunotherapy with rIL-2 has also been reported in the treatment of angiosarcoma of the scalp.


METHODS
The data of 20 patients with angiosarcoma of the scalp treated with curative RT plus rIL-2 immunotherapy between January 1988 and June 2002 were retrospectively analyzed. The total radiation dose was 70.3 +/- 6.9 Gy. The fractions were 2-3 Gy daily, given 5 d/wk. rIL-2 immunotherapy was performed by transcatheter arterial administration in 10 patients, systemic administration in 11 during the course of RT, and intratumoral injection in 10 during and/or after RT; 12 patients received a combination of two. Five patients underwent limited surgery, and concomitant pacilitaxel chemotherapy was also used in 2 patients.


RESULTS
The median survival time for overall, local recurrence-free, and distant metastasis-free survival was 36.2, 11.1, and 17.8 months, respectively. Local recurrence developed in 7 patients (35%), 4 of whom also had evidence of distant metastases. An additional 7 patients (35%) developed distant metastases alone. Recurrence within the radiation field was recognized in 2 patients with systemic rIL-2 administration alone (p < 0.05). Arterial or intratumoral administration combined with systemic administration of rIL-2 resulted in better distant metaststasis-free survival rates (p < 0.05).


CONCLUSIONS
Curative RT plus rIL-2 immunotherapy provided an efficient, effective means of treating angiosarcoma of the scalp. Arterial or intratumoral administration combined with systemic administration of rIL-2 may prolong survival. Additional studies with detailed treatment protocols are recommended.
Ohguri
Takayuki
T
Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan. ogurieye@med.uoeh-u.ac.jp
Imada
Hajime
H
Nomoto
Satoshi
S
Yahara
Katsuya
K
Hisaoka
Masanori
M
Hashimoto
Hiroshi
H
Tokura
Yoshiki
Y
Nakamura
Katsumasa
K
Shioyama
Yoshiyuki
Y
Honda
Hiroshi
H
Terashima
Hiromi
H
Moroi
Yoiichi
Y
Furue
Masutaka
M
Korogi
Yukunori
Y
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D006394:Hemangiosarcoma / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007376:Interleukin-2 / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012535:Scalp; D012878:Skin Neoplasms / Q000532:radiotherapy / Q000628:therapy*
D000970:Antineoplastic Agents; D007376:Interleukin-2; D011994:Recombinant Proteins