title: Local treatment with electrochemotherapy of superficial angiosarcomas: Efficacy and safety results from a multi-institutional retrospective study.
abstract: BACKGROUND
  Angiosarcoma is an aggressive vascular neoplasm with a high propensity for local recurrence. Electrochemotherapy is an emerging skin-directed therapy, exerting prominent cytotoxic activity, and antivascular effects. Its efficacy in angiosarcoma has not been investigated.
  
  
  METHODS
  This multicenter retrospective analysis reviewed patients who underwent electrochemotherapy from 2007 to 2014 for superficial advanced angiosarcomas. Bleomycin was administered intravenously and delivered within tumors by means of percutaneously applied electric pulses, according to the European Standard Operating Procedures for Electrochemotherapy. Tumor assessment was performed using RECIST (version 1.1). Toxicity (CTCAE, v4.0) and local progression-free survival (LPFS) were also evaluated.
  
  
  RESULTS
  Nineteen patients (13 with locally advanced and 6 with metastatic angiosarcomas) were treated. Tumor sites were: scalp (n = 5), breast (n = 8), other skin sites (n = 3), and soft tissue (n = 3). Target lesions (n = 54) ranged in size from 1.5 to 2.5 cm (median, 2 cm). Treatment was well tolerated. After 2 months, an objective response was observed in 12/19 (63%) patients, complete in 8 (42%). One-year LPFS within treatment field was 68%. Local symptom improvement included palliation of bleeding (5/19 patients) and pain relief (6/19 patients).
  
  
  CONCLUSIONS
  Electrochemotherapy may represent a new locoregional treatment for selected patients with superficial angiosarcomas. J. Surg. Oncol. 2016;114:246-253. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Medical Oncology Unit, Istituto dei Tumori, Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Guida
authors.affiliation: Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.|Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.
authors.forename: Luca G
authors.initials: LG
authors.lastname: Campana
authors.affiliation: Department of Dermatology and Plastic Surgery, La Sapienza University, Roma, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Curatolo
authors.affiliation: Medical Oncology Unit, Istituto dei Tumori, Bari, Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: Strippoli
authors.affiliation: Plastic Surgery Unit, San Gallicano Dermatologic Institute IRCCS IFO, Roma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bonadies
authors.affiliation: Breast Surgery Unit, Città della salute e della scienza di Torino, Italy.
authors.forename: Gretha
authors.initials: G
authors.lastname: Grilz
authors.affiliation: Oncologic Surgery, Ospedale Oncologico A. Businco, Cagliari, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cabula
authors.affiliation: Department of Dermatology and Plastic Surgery, La Sapienza University, Roma, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Rotunno
authors.affiliation: Plastic Surgery Unit, San Gallicano Dermatologic Institute IRCCS IFO, Roma, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bucher
authors.affiliation: Surgical Unit 1, San Martino IST-IRCCS, Genova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Solari
authors.affiliation: Dipartimento di chirurgia generale e specialistica II Università di Napoli, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoriello
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.|Medical Oncology, The Christie NHS Trust, Manchester, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Valpione
authors.affiliation: Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.|Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.
authors.forename: Carlo R
authors.initials: CR
authors.lastname: Rossi
mesh_terms: D000368:Aged; D001761:Bleomycin / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy; D053672:Electrochemotherapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006394:Hemangiosarcoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D012189:Retrospective Studies; D012535:Scalp; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001761:Bleomycin
keywords: bleomycin; drug delivery systems; electrochemotherapy; hemangiosarcoma; local; neoplasm recurrence; vascular neoplasms