Angiosarcoma of the Eyelid and Periorbital Region. Experience in Leiden with Iridium192Brachytherapy and Low-Dose Doxorubicin Chemotherapy

Abstract

Aim: To report on the use of iridium¹⁹² brachytherapy and doxorubicin chemotherapy as adjuvant therapy in 6 patients with angiosarcoma of the eyelid and periorbital region. Material and Methods: Tumor localization and diameter, signs of inflammation, histology and treatment are discussed in this retrospective study of 6 patients (age 46–87 yrs.) presenting with primary angiosarcoma in the eyelid. Results: Six patients (4 elderly) with angiosarcoma localized in one or more eyelids, the face or multilocular were seen between 1987 and 2000. In one patient, a small nodular tumor did not recur within 4 years after radical excision. In another patient, the tumor was treated with surgery and iridium¹⁹² wire brachytherapy and did not recur in 17 years of follow-up. In four patients with large diffuse tumors that were treated with doxorubicin, partial regression was achieved. The follow-up was >3 years (median 5 years). Conclusion: If radical surgery for angiosarcoma of the eyelid and periorbital region is not possible, adjuvant iridium¹⁹² wire brachytherapy may prove beneficial. For widespread, diffusely growing tumors, and in elderly patients, low-dose (slowly, 20 mg i.v.) doxorubicin can be used weekly as adjuvant therapy, resulting in partial regression and longer survival rates than previously published by other authors.