Role of Radiotherapy in the Management of Desmoid Tumors

Gluck, Iris; Griffith, Kent A.; Biermann, J. Sybil; Feng, Felix Y.; Lucas, David R.; Ben‐Josef, Edgar

doi:10.1016/j.ijrobp.2010.02.053

Cited by 70 publications

(68 citation statements)

References 22 publications

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“…In several studies, it has been reported that positive surgical margin significantly influences local recurrence rates, while others have not demonstrated any association (19)(20)(21). In a retrospective series, the probability of recurrence was reported to be 20-30% in patients with a negative resection margin, and 50-90% after incomplete surgical resection (21,22). In our study, LC rate was superior for patients with negative surgical margins than positive margins (80% vs 53%); however, the difference was not significant, which may be related to the small and unbalanced sample size.…”

Section: Discussionmentioning

confidence: 99%

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The Role of Radiotherapy in the Treatment of Primary or Recurrent Desmoid Tumors and Long-Term Results

et al. 2016

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Background: Desmoid tumors are uncommon and benign mesenchymal neoplasms. The optimal treatment of patients with desmoid tumors is still controversial. Surgery is the primary treatment for locally invasive or recurrent desmoid tumors. Also, radiotherapy is a treatment option for patients at high risk for local failure such as those with positive margins or recurrent and unresectable tumors. Aims: To report our institutional experience and longterm results of patients with desmoid tumors who received radiotherapy. Study Design: Retrospective cross-sectional study. Methods: Between 1980 and 2009, 20 patients who received radiotherapy (RT) in our institution were analyzed. The majority of patients (80%) were referred with a recurrent tumor after previous surgery. Thirteen patients underwent marginal resection, 4 had wide local excision and 3 patients had only biopsy. Resection margin was positive in 15 (75%) patients. All patients received radiation therapy. The median prescribed dose was 60 Gy. Five patients received less than 54 Gy. Results: The median follow-up time was 77.5 months (28-283 months). Nine patients developed local recurrence after RT. Seven local failures (78%) were in field. Time to local recurrence ranged from 3-165 months (median 33 months). The 2-5 year local control (LC) rates were 80% and 69%, respectively. On univariate analysis, the 5 year local control rate was significantly better in the patients treated with ≥54 Gy than in patients who received <54 Gy (p=0.023). The most common acute side effect was grade 1-2 skin toxicity. As a late side effect of radiotherapy, soft tissue fibrosis was detected in 10 patients and lymphangitis was seen in 1 patient. One patient developed radiation-induced sarcoma. Conclusion: According to our results, radiotherapy is especially effective in recurrent disease and provides a high local control rate in the patients received more than 54 Gy.

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Section: Discussionmentioning

confidence: 99%

“…In our study, LC rate was superior for patients with negative surgical margins than positive margins (80% vs 53%); however, the difference was not significant, which may be related to the small and unbalanced sample size. There are some series showing considerable correlation between tumor localization and surgical margin (21,22).…”

Section: Discussionmentioning

confidence: 99%

The Role of Radiotherapy in the Treatment of Primary or Recurrent Desmoid Tumors and Long-Term Results

et al. 2016

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“…Neoadjuvant or adjuvant radiation is occasionally performed, but its use is controversial. Conflicting studies have shown either no difference in recurrence rate following adjuvant therapy (21) or a delayed time to recurrence with no impact on overall survival (22). Patients with contraindications to surgery or radiotherapy can undergo medical treatment.…”

Section: Discussionmentioning

confidence: 99%

Contralateral recurrence of aggressive fibromatosis in a young woman: A case report and review of the literature

2015

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Abstract. Aggressive fibromatosis (AF) is a benign non-encapsulated tumor of mesenchymal origin, with a tendency for local spread along fascial planes. Local invasion can lead to extensive morbidity and even mortality due to destruction of the bones, organs and soft tissues. This rare lesion is observed 1,000 times more frequently in patients with familial adenomatous polyposis or Gardner's syndrome due to the inheritance of the adenomatous polyposis coli (APC) gene. While AF does not metastasize, local recurrence is common. Distant recurrence is extremely rare, but is observed in those with a germ line APC mutation. The present study details the case of a 20-year-old woman with a melanoma of the right shoulder, treated definitively with surgery. The patient then developed a painful mass at the surgical site; a surgical biopsy demonstrated that the mass was AF. The patient was treated with surgical resection, radiation therapy, and a course of tamoxifen. Five years later, the patient presented with left forearm pain and diminished range of motion due to an infiltrating mass. This was excised and a clinical diagnosis of recurrent AF was made, in this patient lacking familial predisposition to the disease.

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“…The 1997 Goy et al 9 study found that 2% of patients were disabled, 2% had above-the-knee amputation, and 7% needed reconstructive surgery. The 2011 Gluck et al 27 study reported that 2% of patients had chronic pain.…”

Section: Local Control Ratementioning

confidence: 99%

“…One study used the U.S. National Cancer Institute Common Terminology Criteria for Adverse Events to assess rt toxicity 29 , three studies used their own criteria 9,16,22 , and four studies did not clarify the criteria used to assess toxicities or complications 6,18,21,27 .…”

Section: Local Control Ratementioning

confidence: 99%

A Systematic Review of Active Treatment Options in Patients with Desmoid Tumours

et al. 2014

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Role of Radiotherapy in the Management of Desmoid Tumors

Cited by 70 publications

References 22 publications

The Role of Radiotherapy in the Treatment of Primary or Recurrent Desmoid Tumors and Long-Term Results

The Role of Radiotherapy in the Treatment of Primary or Recurrent Desmoid Tumors and Long-Term Results

Contralateral recurrence of aggressive fibromatosis in a young woman: A case report and review of the literature

A Systematic Review of Active Treatment Options in Patients with Desmoid Tumours

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