Neoadjuvant chemotherapy for radiation associated angiosarcoma (RAAS) of the breast: A retrospective single center study
Stijn J.C. van der Burg,
Sophie J.M. Reijers,
Anke Kuijpers,
Lotte Heimans,
Astrid N. Scholten,
Rick L.M. Haas,
Hester van Boven,
Willemijn M. Kolff,
Marie-Jeanne T.F.D. Vrancken Peeters,
Martijn Kerst,
Beatrijs A. Seinstra,
Neeltje Steeghs,
Winette T.A. van der Graaf,
Yvonne M. Schrage,
Winan J. van Houdt
Affiliations
Stijn J.C. van der Burg
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Sophie J.M. Reijers
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Anke Kuijpers
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Lotte Heimans
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Medical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Astrid N. Scholten
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Radiotherapy, Plesmanlaan 121, Amsterdam, the Netherlands
Rick L.M. Haas
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Radiotherapy, Plesmanlaan 121, Amsterdam, the Netherlands
Hester van Boven
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Pathology, Plesmanlaan 121, Amsterdam, the Netherlands
Willemijn M. Kolff
Amsterdam University Medical Centre, Department of Radiotherapy, Meibergdreef 9, Amsterdam, the Netherlands
Marie-Jeanne T.F.D. Vrancken Peeters
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Martijn Kerst
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Medical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Beatrijs A. Seinstra
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Radiology, Plesmanlaan 121, Amsterdam, the Netherlands
Neeltje Steeghs
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Medical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Winette T.A. van der Graaf
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Medical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Yvonne M. Schrage
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands
Winan J. van Houdt
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL), Department of Surgical Oncology, Plesmanlaan 121, Amsterdam, the Netherlands; Corresponding author. Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam the Netherlands.
Background: Radiation associated angiosarcoma (RAAS) of the breast is a rare malignancy with poor survival. Optimal treatment strategies remain uncertain due to a lack of data, and vary between surgery alone and a combination of surgery with (neo)adjuvant chemotherapy (NACT) and/or re-irradiation. The aim of this study was to evaluate the potential benefit of taxane based NACT. Methods: In this retrospective single center study, all patients with RAAS of the breast treated between 1994 and 2024 are included. Since 2018, NACT is considered a treatment option for this patient population in our institute. The difference in oncological outcomes of patients with and without NACT were compared. Results: Thirty-five women were included. Thirteen (37 %) received NACT of which five (39 %) also had neoadjuvant re-irradiation with hyperthermia. Eleven patients (85 %) received paclitaxel, the other two (15 %) had doxorubicine/docetaxel. Complete pathological response was found in 69 % (n = 9). Median follow up was 41 months (range 24–56) for patients with NACT and 44 (range 20–108) for patients without NACT. In the NACT group, only one patient developed a recurrence after 6.5 years. Patients with NACT had improved oncological outcomes compared to patients without NACT in terms of 3-year local recurrence free survival (100% vs. 63.9 %, p = 0.14), distant metastasis free survival (100 % vs. 47.5 %, p = 0.005), and overall survival (100% vs. 56.1 %, p = 0.016). Conclusion: In this study, neoadjuvant taxanes for RAAS of the breast leads to improved distant metastasis free survival and overal survival in patients treated with NACT compared to no NACT