Radiotherapy Is Effective for Desmoid Tumors (Aggressive Fibromatosis) - Long-Term Results of a German Multicenter Study

Abstract

Background: Desmoids (aggressive fibromatosis) are defined as benign neoplasms of the connective tissue that arise from the deep muscle fascia, aponeurosis, tendons, and scar tissue. Recurrence rates between 40 and 80% were reported after surgery alone. We addressed the impact of radiation therapy (RT) in the management of aggressive fibromatosis. Patients and Methods: A large literature review was performed, and the data was compared with the results of a multicenter study of the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD). Results: This analysis included 52 patients treated with RT. 37 patients received postoperative RT (20 patients after R2 resection and 17 patients after R1 resection). 15 patients received RT alone (6 patients with inoperable primary tumor and 9 patients with inoperable recurrent tumor). In the case of postoperative RT, a median dose of 50 Gy (range 50-60 Gy) was used; for definitive RT, a median dose of 55 Gy (range 55-65 Gy) was used. The local control rate was 79% for the whole group. The median follow-up was 44 month (range 8-62 months). Conclusion: Given the large number of patients, these data show that RT is highly effective in the treatment of desmoid tumors. RT is an attractive alternative to mutilating surgery.

Meta-analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid-type fibromatosis

“…Sufficient data for analysis were published in two articles; authors from the other 50 articles were contacted and requested to provide the additional data needed. Of these, 14 responded, bringing the total number of included studies to 16 ( Fig. ).…”

“…Baumert et al 36 Bertani et al 37 Bonvalot et al 11 Cates and Stricker 24 Eastley et al 38 Gronchi et al 22 Huang et al 39 Ihalainen et al 40 Kriz et al 41 Pignatti et al 42 Prodinger et al 43 Salas et al 25 Stoeckle et al 44 van Broekhoven et al 23 Wang et al 45 Wilkinson et al 46 Total Heterogeneity: 37 Bonvalot et al 11 Cates and Stricker 24 Eastley et al 38 Gronchi et al 22 Huang et al 39 Ihalainen et al 40 Kriz et al 41 Pignatti et al 42 Prodinger et al 43 Salas et al 25 Stoeckle et al 44 van Broekhoven et al 23 Wang et al 45 Wilkinson et al 46 Total Heterogeneity: χ 2 = 7·97, 3 d.f., P = 0·05; I 2 = 62% Test for overall effect: Z = 2·50, P = 0·01 Bertani et al 37 Bonvalot et al 11 Cates and Stricker 24 Eastley et al 38 Gronchi et al 22 Huang et al 39 Ihalainen et al 40 Kriz et al 41 Pignatti et al 42 Prodinger et al 43 Salas et al 25 Stoeckle et al 44 van Broekhoven et al 23 Wang et al…”

Early experience: high-intensity focused ultrasound treatment for intra-abdominal aggressive fibromatosis of failure in surgery

“…Patients who are not surgical candidates or who refuse surgery are indicated for radiation therapy alone, and several studies have shown that radiation therapy alone results in durable local control rates of 70-80%. 2,[13][14][15] However, studies on radiotherapy have focused on extra-abdominal aggressive fibromatosis, and most of the tumour sizes are significantly ,10 cm; therefore, the median total dose of 56 Gy has a better therapeutic effect on local control. In this study, all of the tumours were diagnosed as intra-abdominal aggressive fibromatosis with sizes .10 cm.…”

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

“…Woltsche et al (13) and Soto-Miranda et al (14) found the condition of the resection margin does not impact the local control rate of surgery, which indicated that DT has unique biological behavior, challenges the effectiveness of radical resection and highlights the need of adjuvant therapy like chemotherapy.…”