HELICAL tomotherapy combined with paclitaxel demonstrated encouraging survival outcomes with manageable toxicity in patients with cutaneous angiosarcoma. This is according to a retrospective analysis. The findings highlight a potential treatment option that may improve disease control while reducing the toxicity associated with high-dose radiotherapy alone.
Cutaneous angiosarcoma is an aggressive malignancy traditionally treated with high-dose radiotherapy, yet the risks of adverse events and organ damage have limited treatment tolerability. Intensity-modulated radiation therapy delivered through tomotherapy allows precise targeting of complex lesions, potentially mitigating these risks.
Researchers evaluated 12 patients with cutaneous angiosarcoma treated with tomotherapy and paclitaxel between January 2017 and April 2024. Outcomes included progression-free survival, overall survival, and adverse event profiles, with results compared against historical controls.
The analysis showed a median progression-free survival of 10.5 months, with a 2-year overall survival rate of 70.0% and a 2-year progression-free survival rate of 41.7%. Severe treatment-related toxicities were limited, with grade 3 or higher events including radiation-induced dermatitis in one patient, neutropenia in two, peripheral neuropathy in one, and corneal toxicity in one. Importantly, the majority of patients tolerated the combined regimen well.
These results suggest that tomotherapy combined with paclitaxel offers a favorable balance between efficacy and safety in cutaneous angiosarcoma management. While the small sample size and retrospective design limit definitive conclusions, the data point toward a viable therapeutic strategy for a disease with few effective options. Further prospective evaluation will be essential to confirm these outcomes and define the optimal role of this approach in clinical practice.
Reference: Aoki M et al. Efficacy and Safety of Helical Tomotherapy Combined With Paclitaxel in Cutaneous Angiosarcoma. J Dermatol. 2025. doi: 10.1111/1346-8138.17981
