- 期刊
Angiosarcoma of the Scalp - A Devastating Cutaneous Malignancy of the Elderly
頭皮血管肉瘤──不良預後的老年人惡性皮膚腫瘤
摘要
Background: Cutaneous angiosarcoma of the scalp is a rare and aggressive malignant tumor of the vascular endothelial cells. Multimodality therapy involving wide excision combined with radiation therapy and chemotherapy is the most common treatment for angiosarcoma. However, the prognosis of patients with angiosarcoma remains poor. Aim and Objectives: This retrospective study investigated the clinical presentation and outcomes of treatment for patients with scalp angiosarcoma treated at Taichung Veterans General Hospital from 2001 to 2020. Materials and Methods: The International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) section on hemangiosarcoma (M9120/3) was used to identify patients with angiosarcoma. We excluded patients who had surgery before 2001, a non-scalp tumor, or incomplete documentation. Ten patients were diagnosed with scalp angiosarcoma and treated between 2001 and 2020. We manually reviewed the medical charts of the patients to collect data on patient characteristics. Results: We analyzed the data of 10 patients, specifically 8 men and 2 women with an average age of 75.1 years. The median tumor diameter was 4.71 cm. All patients underwent surgery, regardless of receiving adjuvant therapy. The median time from surgery to death was 15.6 months. The mean disease-free survival time was 5.9 months, and the 2-year overall survival rate was 20%. Conclusion: Cutaneous angiosarcoma of the scalp is difficult to control and treat. Challenges include optimizing treatment to prevent local and regional recurrence as well as metastasis. In our study, limited by the small number of patients, multimodal therapy only negligibly improved long-term survival. However, multimodal therapy combined with both surgery and radiation therapy can still prolong a patient's lifespan. Additional studies are needed to determine the prognosis respect to pathophysiology. In addition, large multicenter-based and well-controlled studies on systematic agents should be conducted.
並列摘要
背景：頭皮血管肉瘤為罕見皮膚惡性腫瘤，好發於老年男性，早期表現變化多且不起眼而容易忽視，具高度局部再發與遠端轉移特性。目的及目標：本研究旨在回顧與評量台中榮總治療頭皮血管肉瘤經驗並加以分析討論。材料及方法：我們利用回溯分析腫瘤特性與臨床治療方法，從2001到2020，共有10為頭皮血管肉瘤患者於台中榮民總醫院接受治療。病患平均年齡約75.1歲，男性8名，女性2名。所有病人均接受手術切除，8位病人接受手術與放射治療或化學治療的綜合治療。結果：10位病人中，病理報告呈現腫瘤完全切除者共7名。8位患者發生局部復發，8位患者發生遠端轉移，自手術治療至死亡平均時間約15.6月，二年存活率20%。結論：治療頭皮血管肉瘤目前廣為接受的方法是手術合併放射治療，然而其外觀的多樣性與高度復發的可能性，在本院的治療經驗中，即使能做到腫瘤完全切除，大多數患者仍在短時間內發生復發。對於衛星病灶的判讀以及全身系統性的治療，仍需更進一步研究。