In a patient with solitary metastasis skin/subcutaneous wrist, resected with graft, from a primary breast angiosarcoma, what would be your preferred fields and dose?
50+ yo F. Mastectomy, chemo, and RT in 2016 for primary breast angiosarcoma, not RT induced. Had longstanding cyst on wrist, biopsied, and positive for angiosarcoma. Resection of ~3 cm angiosarcoma, with negative margins. Reconstructed with split thickness skin graft. S/p adjuvant gem and docetaxel chemotherapy.
2 Answers
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Radiation Oncology · The Ohio State University - James Cancer Hospital and Solove Research Institute
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Agree, odd presentation. Hopefully, the patient was fully staged with PET and MRI brain after this was diagnosed to confirm solitary metastasis. If so, agree with chemo first; angiosarcoma in general, has formidable DM risk (though hard to know how much that applies to this presentation) so makes se...
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Radiation Oncology · Allegheny Health Network, Pittsburgh
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This is an uncommon patter of distant metastatic spread with long natural history from the original diagnosis. I would consider standard postop (60/30) given single site and 6 years; alternatively, given distant metastatic disease one could consider a hypofractionated regimen, I have used 32-40/8-10...
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