Low-dose dacarbazine-doxorubicin therapy against intra-abdominal desmoid tumors

Abstract

Abstract. Intra-abdominal desmoid tumor is a lifethreatening disease. Studies have shown that dacarbazine (DTIC)-doxorubicin (DOX) (D-D) therapy is the most effective treatment. However, myelosuppression is a major problem, and cardiac muscle disorders due to DOX limit the number of administration cycles, whereas it usually requires a long time to achieve tumor shrinkage. To resolve these issues, we introduced low-dose D-D therapy to 3 patients employing 50 mg/m 2 DOX and 600-700 mg/m 2 DTIC per cycle, which permits repeated administration cycles up to 10-11 times. Case 1 was a 23-year-old female with a sporadic recurrent mesenterium desmoid tumor located in the pelvis (maximum diameter, 8 cm). Cases 2 and 3 were a 33-year-old female and a 36-year-old male. Both patients had intra-abdominal mesenterium desmoid tumors (maximum diameter 9.6 and 9.0 cm, respectively) that were generated after proctocolectomy due to familial adenomatous polyposis. No severe adverse events occurred during the therapy. With the aid of sulindac and tamoxifen after low-dose D-D therapy, the first two patients achieved a complete response, and the third patient achieved a partial response and awaits further tumor shrinkage. Our experience indicates that low-dose DT-D therapy is a safe and effective regimen for patients with intra-abdominal desmoid tumors.

Efficacy of vinorelbine combined with low-dose methotrexate for treatment of inoperable desmoid tumor and prognostic factor analysis

“…Neurotoxicity of NVB is less than that of VBL, and the therapeutic effect is the same (31). MTX+VBL therapy was used in 27 cases in Garbay's study (23). The median chemotherapy duration lasted for 18 weeks, 4 patients achieved PR (15%), 14 achieved SD (52%), and 9 suffered PD (33%).…”

“…All of the patients had remission. In Garbay's study (23), combined chemotherapy was delivered in 44 (71%) cases, monotherapy in 18 (29%) patients, and 13 (21%) patients received an anthracyclinecontaining regimen. The most common nonanthracycline regimen was MTX-VBL combination (n=27).…”

Intestinal perforation during chemotherapeutic treatment of intra-abdominal desmoid tumor in patients with Gardner’s syndrome: report of two cases

“…It has been reported that cytotoxic-chemotherapy benefits about 20 to 75 % of treated desmoid patients [ 19 ]. Several studies indicated the efficacy and safety of the chemotherapy regimen of doxorubicin and dacarbazine combination in treating patients with Gardner’s syndrome-associated desmoid tumors [ 8 , 9 , 20 , 21 ]. Gega combined DOX, DTIC, and meloxicam in the treatment of Gardner’s syndrome-associated desmoids and achieved a great success with high rates of partial or complete response [ 8 ].…”

“…Alternatively, we speculate that reduction of the dosage may eliminate the adverse effect of DOX-DTIC-meloxicam. In fact, Yamaoto employed low-dose DOX-DTIC therapy to three patients against intra-abdominal desmoids, which was a safe and effective regimen and permitted repeated administration cycles (50 mg/m 2 DOX and 600–700 mg/m 2 DTIC per cycle) up to 10–11 times [ 21 ].…”

Desmoid-Type Fibromatosis of the Mesentery: Report of a Sporadic Case with Emphasis on Differential Diagnostic Problems

“…The poor results obtained by surgery on the treatment of relapse, also because of the hyperplasiogenous stimulus that such treatment determines, have made this approach a secondary choice or at least one which follows complementary treatments such as radiation therapy, which seems to achieve a control of tumor growth in 40 to 80% of cases [ 4 , 10 , 29 ].…”