For unresectable radiation induced angiosarcoma, what dose and fractionation would you use?  

45 Gy at 1 Gy TID with 10 cm margins, boost to 60 Gy with same fractionation with 5 cm margins. If still incompletely resectable, 75 Gy. Outcomes have been published by NPM. 

If localized, would start with taxane-based chemo. This may downstage the tumor a bit and will provide a window of chemoselection to prove the patient isn't going to develop early metastatic disease that would make local therapy futile. Once response plateaus or toxicity mounts, conventionally fract...