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Efficacy of weekly docetaxel in locally advanced cardiac angiosarcoma.

Minichillo S, Pantaleo MA, Nannini M, Coccolo F, Gatto L, Biasco G, Brandi G - BMC Res Notes (2015)

Bottom Line: Primary cardiac angiosarcoma is extremely aggressive; however, it is often misdiagnosed because of its rarity.For locally advanced tumors, doxorubicin-based chemotherapy regimens are the standard of treatment, even if the gain in term of progression-free survival is limited and is no longer than 5 months.Combined treatment with weekly docetaxel and radiotherapy may be a valid alternative for the treatment of locally advanced cardiac angiosarcoma; the combination can lead to radical surgical resections, avoiding the cumulative cardiotoxicity of antracycline-based regimens.

View Article: PubMed Central - PubMed

Affiliation: Department of Specialized, Experimental and Diagnostic Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy. med.minichillo@hotmail.it.

ABSTRACT

Background: Primary cardiac angiosarcoma is extremely aggressive; however, it is often misdiagnosed because of its rarity. For locally advanced tumors, doxorubicin-based chemotherapy regimens are the standard of treatment, even if the gain in term of progression-free survival is limited and is no longer than 5 months.

Case presentation: We report the case of a Caucasian 23-year-old man with locally advanced cardiac angiosarcoma who underwent radical surgical resection after a prolonged response to weekly docetaxel and complementary radiotherapy.

Conclusion: Combined treatment with weekly docetaxel and radiotherapy may be a valid alternative for the treatment of locally advanced cardiac angiosarcoma; the combination can lead to radical surgical resections, avoiding the cumulative cardiotoxicity of antracycline-based regimens.

No MeSH data available.


Related in: MedlinePlus

Nuclear magnetic resonance imaging after neoadjuvant therapy with docetaxel (24 administrations).
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Fig2: Nuclear magnetic resonance imaging after neoadjuvant therapy with docetaxel (24 administrations).

Mentions: Surgical treatment with radical intent was initially excluded, given the size of the mass, its location close to the coronary ostium and the suspicion of extracardiac involvement. Therefore, a combined radiochemotherapeutic neoadjuvant treatment was planned. In order to preserve myocardial function as much as possible to allow for a subsequent surgical resection, doxorubicin was avoided, and first-line treatment with docetaxel was chosen. From June 2008 to September 2008, the patient was treated with four cycles of weekly docetaxel (35 mg/mq) with excellent tolerance. The subsequent NMR revaluation showed the disappearance of pulmonary nodules and a reduction of the atrial mass by about 1 cm. Subsequently, percutaneous conformal radiotherapy at a total dose of 5,400 centigray (cGy), with a daily fractionation of 180 cGy was performed, followed by 13 additional infusions of weekly docetaxel at the previous dose. Although the radiological revaluation confirmed a further reduction in size of the cardiac mass and a reduction in size of mediastinic adenopathies, the surgical resection was still excluded. Therefore the patient continued chemotherapy, receiving a total of 24 cycles of weekly docetaxel, until May 2009. Since a further reduction of 1.2 cm in size of the atrial mass was found by NMR (Fig. 2) and CT-PET scan, the surgical treatment was performed in July 2009. After surgery, the patient was treated again with weekly docetaxel for a total of 10 cycles in the adjuvant setting with overall good tolerance. A follow-up radiological revaluation (NMR, PET) did not show any signs of recurrence. A close follow-up was set during which several evacuative thoracenteses were performed because of a recurrent bilateral neoplastic pleural effusion until the patient died in April 2010 of respiratory failure about 2 years after diagnosis. The last radiological assessment showed progressive disease with pleural and liver metastasis.Fig. 2


Efficacy of weekly docetaxel in locally advanced cardiac angiosarcoma.

Minichillo S, Pantaleo MA, Nannini M, Coccolo F, Gatto L, Biasco G, Brandi G - BMC Res Notes (2015)

Nuclear magnetic resonance imaging after neoadjuvant therapy with docetaxel (24 administrations).
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4519000&req=5

Fig2: Nuclear magnetic resonance imaging after neoadjuvant therapy with docetaxel (24 administrations).
Mentions: Surgical treatment with radical intent was initially excluded, given the size of the mass, its location close to the coronary ostium and the suspicion of extracardiac involvement. Therefore, a combined radiochemotherapeutic neoadjuvant treatment was planned. In order to preserve myocardial function as much as possible to allow for a subsequent surgical resection, doxorubicin was avoided, and first-line treatment with docetaxel was chosen. From June 2008 to September 2008, the patient was treated with four cycles of weekly docetaxel (35 mg/mq) with excellent tolerance. The subsequent NMR revaluation showed the disappearance of pulmonary nodules and a reduction of the atrial mass by about 1 cm. Subsequently, percutaneous conformal radiotherapy at a total dose of 5,400 centigray (cGy), with a daily fractionation of 180 cGy was performed, followed by 13 additional infusions of weekly docetaxel at the previous dose. Although the radiological revaluation confirmed a further reduction in size of the cardiac mass and a reduction in size of mediastinic adenopathies, the surgical resection was still excluded. Therefore the patient continued chemotherapy, receiving a total of 24 cycles of weekly docetaxel, until May 2009. Since a further reduction of 1.2 cm in size of the atrial mass was found by NMR (Fig. 2) and CT-PET scan, the surgical treatment was performed in July 2009. After surgery, the patient was treated again with weekly docetaxel for a total of 10 cycles in the adjuvant setting with overall good tolerance. A follow-up radiological revaluation (NMR, PET) did not show any signs of recurrence. A close follow-up was set during which several evacuative thoracenteses were performed because of a recurrent bilateral neoplastic pleural effusion until the patient died in April 2010 of respiratory failure about 2 years after diagnosis. The last radiological assessment showed progressive disease with pleural and liver metastasis.Fig. 2

Bottom Line: Primary cardiac angiosarcoma is extremely aggressive; however, it is often misdiagnosed because of its rarity.For locally advanced tumors, doxorubicin-based chemotherapy regimens are the standard of treatment, even if the gain in term of progression-free survival is limited and is no longer than 5 months.Combined treatment with weekly docetaxel and radiotherapy may be a valid alternative for the treatment of locally advanced cardiac angiosarcoma; the combination can lead to radical surgical resections, avoiding the cumulative cardiotoxicity of antracycline-based regimens.

View Article: PubMed Central - PubMed

Affiliation: Department of Specialized, Experimental and Diagnostic Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy. med.minichillo@hotmail.it.

ABSTRACT

Background: Primary cardiac angiosarcoma is extremely aggressive; however, it is often misdiagnosed because of its rarity. For locally advanced tumors, doxorubicin-based chemotherapy regimens are the standard of treatment, even if the gain in term of progression-free survival is limited and is no longer than 5 months.

Case presentation: We report the case of a Caucasian 23-year-old man with locally advanced cardiac angiosarcoma who underwent radical surgical resection after a prolonged response to weekly docetaxel and complementary radiotherapy.

Conclusion: Combined treatment with weekly docetaxel and radiotherapy may be a valid alternative for the treatment of locally advanced cardiac angiosarcoma; the combination can lead to radical surgical resections, avoiding the cumulative cardiotoxicity of antracycline-based regimens.

No MeSH data available.


Related in: MedlinePlus