Angiosarcoma of the eyelid and periorbital region. Experience in Leiden with iridium192 brachytherapy and low-dose doxorubicin chemotherapy.
OBJECTIVE
To report on the use of iridium(192) brachytherapy and doxorubicin chemotherapy as adjuvant therapy in 6 patients with angiosarcoma of the eyelid and periorbital region.


METHODS
Tumor localization and diameter, signs of inflammation, histology and treatment are discussed in this retrospective study of 6 patients (age 46-87 yrs.) presenting with primary angiosarcoma in the eyelid.


RESULTS
Six patients (4 elderly) with angiosarcoma localized in one or more eyelids, the face or multilocular were seen between 1987 and 2000. In one patient, a small nodular tumor did not recur within 4 years after radical excision. In another patient, the tumor was treated with surgery and iridium(192) wire brachytherapy and did not recur in 17 years of follow-up. In four patients with large diffuse tumors that were treated with doxorubicin, partial regression was achieved. The follow-up was >3 years (median 5 years).


CONCLUSIONS
If radical surgery for angiosarcoma of the eyelid and periorbital region is not possible, adjuvant iridium(192) wire brachytherapy may prove beneficial. For widespread, diffusely growing tumors, and in elderly patients, low-dose (slowly, 20 mg i.v.) doxorubicin can be used weekly as adjuvant therapy, resulting in partial regression and longer survival rates than previously published by other authors.
de Keizer
R J W
RJ
Department of Opthalmology, Leiden University Medical Center, Leiden, The Netherlands.
de Wolff-Rouendaal
D
D
Nooy
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001918:Brachytherapy; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000627:therapeutic use; D005142:Eyelid Neoplasms / Q000628:therapy*; D005260:Female; D006394:Hemangiosarcoma / Q000628:therapy*; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000628:therapy*; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D012189:Retrospective Studies
D000903:Antibiotics, Antineoplastic; D007496:Iridium Radioisotopes; D019275:Radiopharmaceuticals; D004317:Doxorubicin