Efficacy and Safety of Helical Tomotherapy Combined With Paclitaxel in Cutaneous Angiosarcoma

High-dose radiotherapy is the standard treatment for cutaneous angiosarcoma (CAS); however, adverse events and organ toxicity remain major challenges. Intensity-modulated radiation therapy using tomotherapy allows the precise targeting of complex lesions. We retrospectively reviewed 12 patients with CAS who were treated with tomotherapy and paclitaxel between January 2017 and April 2024. Clinical outcomes, including progression-free survival, overall survival, and adverse events, were analyzed and compared with those of the historical controls. The median progression-free survival was 10.5 months (95% confidence interval: 7.7-not reached). The 2-year overall survival and progression-free survival rates were 70.0% and 41.7%, respectively. Grade ≥ 3 adverse events occurred in a limited number of patients, including radiation-induced dermatitis (n = 1), neutropenia (n = 2), peripheral neuropathy (n = 1), and corneal toxicity (n = 1). Nevertheless, the treatment regimen was generally well tolerated and achieved favorable survival outcomes, representing a safe and effective treatment option.