Case and Research Letter
Unresectable Angiosarcoma Treated With Bevacizumab and Paclitaxel
Angiosarcoma irresecable tratado con bevacizumab y paclitaxel
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Note the erythematous surface, which is papilliform in appearance, and abundant exudate. Several larvae can be seen on the surface of the lesion.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Aguado Lobo, A. Hernández-Núñez, M. Isabel García-Arata, J. Borbujo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Aguado Lobo" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Hernández-Núñez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Isabel García-Arata" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731013002895" "doi" => "10.1016/j.ad.2013.07.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731013002895?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014001206?idApp=UINPBA000044" "url" => "/15782190/0000010500000005/v1_201405281018/S1578219014001206/v1_201405281018/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219014001103" "issn" => "15782190" "doi" => "10.1016/j.adengl.2014.04.004" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "916" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2014;105:519-20" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1273 "formatos" => array:3 [ "EPUB" => 48 "HTML" => 947 "PDF" => 278 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Condyloma Acuminata in Male Patients. 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"apellidos" => "Ruíz Bravo-Burguillos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731013003761" "doi" => "10.1016/j.ad.2013.10.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731013003761?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014001103?idApp=UINPBA000044" "url" => "/15782190/0000010500000005/v1_201405281018/S1578219014001103/v1_201405281018/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Unresectable Angiosarcoma Treated With Bevacizumab and Paclitaxel" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "520" "paginaFinal" => "522" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.V. Nespereira-Jato, C. Peña-Panabad, M. Quindós-Varela, J. García-Silva" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M.V." "apellidos" => "Nespereira-Jato" "email" => array:1 [ 0 => "vnespereira@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Peña-Panabad" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Quindós-Varela" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "García-Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología Hospital Abente y Lago, Complejo Hospitalario Universitario, A Coruña, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Oncología, Hospital Abente y Lago, Complejo Hospitalario Universitario, A Coruña, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Angiosarcoma irresecable tratado con bevacizumab y paclitaxel" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 928 "Ancho" => 901 "Tamanyo" => 128939 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Erythematous violaceous tumor with a 4-cm diameter and peripheral macular lesions.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Angiosarcoma is an aggressive tumor of endothelial origin that is associated with a poor prognosis. The effectiveness of new treatments such as bevacizumab is based on their ability to inhibit angiogenesis; specifically, bevacizumab acts on vascular endothelial growth factor (VEGF), which has been implicated in the pathogenesis of angiosarcoma.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 68-year-old woman who consulted for an erythematous violaceous tumor with a diameter of 1<span class="elsevierStyleHsp" style=""></span>cm on the scalp. Skin biopsy was consistent with a poorly differentiated angiosarcoma. The lesion grew rapidly and within a month it had progressed to a multilobulated, ulcerated tumor affecting the left side of the scalp and the right occipital region; also present in this region were red wine–colored macules measuring 1 to 2<span class="elsevierStyleHsp" style=""></span>cm in diameter (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">A computed tomography (CT) scan ruled out distant disease and the patient was diagnosed with poorly differentiated angiosarcoma (T2b, N0, M0), classified as stage III according to the 2010 American Joint Committee on Cancer staging system.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Immediate surgical treatment was ruled out due to the size of the lesion, which affected over half of the scalp. The patient was treated with neoadjuvant paclitaxel (80<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span>/wk) and bevacizumab (10<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 weeks) and the lesion responded rapidly (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The treatment was completed after 14 cycles (each consisting of 1 bevacizumab infusion and 2 paclitaxel infusions) and was well tolerated. The remaining lesion was surgically removed, and no evidence of angiosarcoma was seen on histology. Despite the negative biopsy results for the area of the tumor, the patient was administered adjuvant radiation therapy (daily fractions of 2<span class="elsevierStyleHsp" style=""></span>Gy, up to a total dose of 50<span class="elsevierStyleHsp" style=""></span>Gy) combined with bevacizumab (5<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 weeks) due to the persistence of a red wine–colored macule in the left preauricular region. Complete response continued following completion of the 2 treatments.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Two months later, however, the patient's general health deteriorated and clinical recurrence of the angiosarcoma was noted in the left preauricular region. The CT scan showed bone metastasis. Combined treatment with paclitaxel and bevacizumab was reinitiated, but the disease progressed and the patient died 14 months after diagnosis.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Angiosarcoma is a rare but very aggressive tumor with high metastatic potential. There are 3 forms, but angiosarcoma of the head and neck–the classic form–is the most common.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The treatment of choice is surgical excision with wide margins followed by adjuvant high-dose wide-field radiotherapy (><span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>Gy).<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,4,5</span></a> Chemotherapy, however, is the only option for patients with advanced or unresectable angiosarcoma, but the effectiveness of different regimens has not been demonstrated in clinical trials.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Additionally, chemotherapy is often limited because of its toxicity.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The most widely used regimens are anthracyclines and taxanes, but response is limited. Prospective studies of paclitaxel in the treatment of cutaneous angiosarcoma have shown a mean survival time of 8 months and a mean disease-free period of 4 months.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The need for new drugs with improved effectiveness and tolerance is thus clear. Interest is currently focused on angiogenesis inhibitors.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Angiosarcoma originates from vascular endothelial cells, and several factors have been implicated in its pathogenesis. One of the most important of these is VEGF-A,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> which is a growth factor involved in the development of new blood vessels through the stimulation of receptors with tyrosine-kinase activity on the surface of endothelial cells. VEGF-A overexpression by neoplastic cells, which has been demonstrated in angiosarcoma and other tumors (of the lung, breast, and colon/rectum) promotes angiogenesis and consequently leads to increased blood supply and faster tumor growth.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,6</span></a> Bevacizumab is a monoclonal antibody that targets VEGF-A, preventing it from binding to its receptor, and thereby inhibiting angiogenesis. Nonetheless, the potential for recurrence and the short disease-free periods observed suggest that there are other factors at play and that VEGF inhibition alone is not sufficient to stop the tumor from growing.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Five cases of cutaneous angiosarcoma treated with bevacizumab, alone or in combination, have been reported to date. A favorable response was reported in all cases, with good tolerance and longer survival than that seen with other treatments (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The results of the first phase II clinical trial on the use of bevacizumab alone to treat metastatic or locally advanced angiosarcoma were recently published by Agulnik et al.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The results are promising, as half of the patients showed stable disease with a mean time to disease progression of 26 weeks.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Considering the scarcity of effective treatments and the results reported to date for bevacizumab in isolated cases and clinical trials, we believe that this drug could be considered in cases similar to the one we have presented. There are also clear indications that bevacizumab used in combination with other drugs could improve the prognosis in patients with angiosarcoma.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Nespereira-Jato MV, Peña-Panabad C, Quindós-Varela M, García-Silva J. Angiosarcoma irresecable tratado con bevacizumab y paclitaxel. Actas Dermosifiliogr. 2014;105:526–528.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 928 "Ancho" => 901 "Tamanyo" => 128939 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Erythematous violaceous tumor with a 4-cm diameter and peripheral macular lesions.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 683 "Ancho" => 901 "Tamanyo" => 113749 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Photograph of lesion after completion of treatment with bevacizumab and paclitaxel.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: AS, angiosarcoma; ND, no data; DFS, disease-free survival; OS, overall survival.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Authors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No. of Cases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Age, y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Tumor Site \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Bevacizumab Doses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Other Treatments \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">DFS, mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">OS, mo \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Koontz et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2008 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5063 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-AS T1N0M0Epithelioid AS T2N0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">FaceFace \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 wk; 4 doses10<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 wk; 3 doses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>surgeryRT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">><span class="elsevierStyleHsp" style=""></span>26<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>8.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NDND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rosen et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AS (ND on TNM) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Face \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 wk, 14 doses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fuller et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AS T2bN0M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Face and neck \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paclitaxel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">><span class="elsevierStyleHsp" style=""></span>11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">De Yao et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AS T2bN0M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Scalp \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 wk, 4 doses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Present case \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AS T2bN0M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Scalp \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>mg/kg every 2 wk; 14 doses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab508510.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cases of Angiosarcoma (AS) Treated With Bevacizumab in the Literature.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angiosarcoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.J. Young" 1 => "N.J. Brown" 2 => "M.W. Reed" 3 => "D. Hughes" 4 => "P.J. Woll" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1470-2045(10)70023-1" "Revista" => array:6 [ "tituloSerie" => "Lancet Oncol" "fecha" => "2010" "volumen" => "11" "paginaInicial" => "983" "paginaFinal" => "991" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20537949" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An open-label, multicenter, phase <span class="elsevierStyleSmallCaps">ii</span> study of bevacizumab for the treatment of angiosarcoma and epithelioid hemangioendotheliomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Agulnik" 1 => "J.L. Yarber" 2 => "A.H. Okuno" 3 => "M. von Mehren" 4 => "B.D. Jovanovic" 5 => "B.E. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 13 | 12 | 25 |
| 2024 Octubre | 108 | 57 | 165 |
| 2024 Septiembre | 98 | 30 | 128 |
| 2024 Agosto | 114 | 36 | 150 |
| 2024 Julio | 88 | 42 | 130 |
| 2024 Junio | 89 | 31 | 120 |
| 2024 Mayo | 92 | 28 | 120 |
| 2024 Abril | 79 | 34 | 113 |
| 2024 Marzo | 87 | 32 | 119 |
| 2024 Febrero | 67 | 30 | 97 |
| 2024 Enero | 61 | 46 | 107 |
| 2023 Diciembre | 64 | 100 | 164 |
| 2023 Noviembre | 65 | 26 | 91 |
| 2023 Octubre | 83 | 28 | 111 |
| 2023 Septiembre | 74 | 29 | 103 |
| 2023 Agosto | 57 | 11 | 68 |
| 2023 Julio | 79 | 33 | 112 |
| 2023 Junio | 75 | 25 | 100 |
| 2023 Mayo | 95 | 22 | 117 |
| 2023 Abril | 49 | 18 | 67 |
| 2023 Marzo | 61 | 25 | 86 |
| 2023 Febrero | 42 | 28 | 70 |
| 2023 Enero | 41 | 23 | 64 |
| 2022 Diciembre | 47 | 40 | 87 |
| 2022 Noviembre | 37 | 26 | 63 |
| 2022 Octubre | 30 | 21 | 51 |
| 2022 Septiembre | 29 | 39 | 68 |
| 2022 Agosto | 23 | 29 | 52 |
| 2022 Julio | 35 | 40 | 75 |
| 2022 Junio | 33 | 20 | 53 |
| 2022 Mayo | 39 | 39 | 78 |
| 2022 Abril | 47 | 39 | 86 |
| 2022 Marzo | 50 | 54 | 104 |
| 2022 Febrero | 29 | 22 | 51 |
| 2022 Enero | 37 | 37 | 74 |
| 2021 Diciembre | 29 | 28 | 57 |
| 2021 Noviembre | 39 | 53 | 92 |
| 2021 Octubre | 32 | 38 | 70 |
| 2021 Septiembre | 35 | 28 | 63 |
| 2021 Agosto | 34 | 31 | 65 |
| 2021 Julio | 27 | 29 | 56 |
| 2021 Junio | 38 | 21 | 59 |
| 2021 Mayo | 29 | 30 | 59 |
| 2021 Abril | 52 | 35 | 87 |
| 2021 Marzo | 57 | 16 | 73 |
| 2021 Febrero | 54 | 26 | 80 |
| 2021 Enero | 41 | 12 | 53 |
| 2020 Diciembre | 33 | 14 | 47 |
| 2020 Noviembre | 21 | 15 | 36 |
| 2020 Octubre | 26 | 12 | 38 |
| 2020 Septiembre | 42 | 10 | 52 |
| 2020 Agosto | 29 | 17 | 46 |
| 2020 Julio | 28 | 18 | 46 |
| 2020 Junio | 24 | 19 | 43 |
| 2020 Mayo | 25 | 12 | 37 |
| 2020 Abril | 27 | 16 | 43 |
| 2020 Marzo | 25 | 11 | 36 |
| 2020 Febrero | 4 | 3 | 7 |
| 2020 Enero | 4 | 0 | 4 |
| 2019 Diciembre | 8 | 1 | 9 |
| 2019 Noviembre | 4 | 2 | 6 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 8 | 0 | 8 |
| 2019 Agosto | 4 | 4 | 8 |
| 2019 Julio | 2 | 0 | 2 |
| 2019 Junio | 5 | 12 | 17 |
| 2019 Mayo | 1 | 6 | 7 |
| 2019 Abril | 0 | 10 | 10 |
| 2019 Marzo | 2 | 5 | 7 |
| 2019 Febrero | 0 | 1 | 1 |
| 2019 Enero | 2 | 1 | 3 |
| 2018 Diciembre | 0 | 1 | 1 |
| 2018 Noviembre | 1 | 3 | 4 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 1 | 0 | 1 |
| 2018 Junio | 0 | 1 | 1 |
| 2018 Mayo | 0 | 4 | 4 |
| 2018 Marzo | 0 | 2 | 2 |
| 2018 Febrero | 33 | 3 | 36 |
| 2018 Enero | 26 | 6 | 32 |
| 2017 Diciembre | 36 | 9 | 45 |
| 2017 Noviembre | 30 | 3 | 33 |
| 2017 Octubre | 31 | 4 | 35 |
| 2017 Septiembre | 50 | 3 | 53 |
| 2017 Agosto | 53 | 14 | 67 |
| 2017 Julio | 54 | 18 | 72 |
| 2017 Junio | 61 | 10 | 71 |
| 2017 Mayo | 58 | 11 | 69 |
| 2017 Abril | 64 | 4 | 68 |
| 2017 Marzo | 39 | 33 | 72 |
| 2017 Febrero | 36 | 11 | 47 |
| 2017 Enero | 29 | 9 | 38 |
| 2016 Diciembre | 40 | 18 | 58 |
| 2016 Noviembre | 54 | 14 | 68 |
| 2016 Octubre | 57 | 8 | 65 |
| 2016 Septiembre | 71 | 11 | 82 |
| 2016 Agosto | 61 | 7 | 68 |
| 2016 Julio | 36 | 4 | 40 |
| 2016 Junio | 6 | 9 | 15 |
| 2016 Mayo | 5 | 2 | 7 |
| 2016 Abril | 1 | 15 | 16 |
| 2016 Marzo | 6 | 7 | 13 |
| 2016 Febrero | 12 | 1 | 13 |
| 2016 Enero | 12 | 4 | 16 |
| 2015 Diciembre | 12 | 3 | 15 |
| 2015 Noviembre | 10 | 10 | 20 |
| 2015 Octubre | 9 | 16 | 25 |
| 2015 Septiembre | 8 | 6 | 14 |
| 2015 Agosto | 16 | 3 | 19 |
| 2015 Julio | 88 | 5 | 93 |
| 2015 Junio | 59 | 4 | 63 |
| 2015 Mayo | 49 | 9 | 58 |
| 2015 Abril | 54 | 14 | 68 |
| 2015 Marzo | 60 | 5 | 65 |
| 2015 Febrero | 45 | 4 | 49 |
| 2015 Enero | 32 | 7 | 39 |
| 2014 Diciembre | 42 | 4 | 46 |
| 2014 Noviembre | 36 | 10 | 46 |
| 2014 Octubre | 34 | 3 | 37 |
| 2014 Septiembre | 32 | 8 | 40 |
| 2014 Agosto | 30 | 10 | 40 |
| 2014 Julio | 21 | 13 | 34 |
| 2014 Junio | 29 | 6 | 35 |
| 2014 Mayo | 3 | 1 | 4 |
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