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Desmoid tumors: a 20-year radiotherapy experience
N E Sherman1, M Romsdahl, H Evans
1Department of Clinical Radiotherapy, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Summary
Radiation therapy effectively controls desmoid tumors, with higher doses not improving outcomes but increasing complications. Adjuvant radiotherapy offers good local control, especially after fewer surgeries.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Desmoid tumors are rare, locally aggressive neoplasms.
- Optimal management often involves a multimodal approach, including surgery and radiation therapy.
- Previous studies have explored radiation therapy's role, but outcomes require further clarification.
Purpose of the Study:
- To evaluate the efficacy and safety of radiation therapy for desmoid tumors.
- To analyze factors influencing local control and complications.
- To assess the impact of prior surgical history on treatment outcomes.
Main Methods:
- Retrospective analysis of 45 patients treated with megavoltage radiation therapy between 1964 and 1984.
- Patients received treatment for inoperable lesions, gross residual disease, or positive margins.
- Doses ranged from 50 to 76.2 Gy, with shrinking field techniques and neutron boost in some cases.
Main Results:
- Tumor control was achieved in 10 of 14 patients with inoperable or gross residual disease.
- Local control probability was 77% for subclinical disease after postoperative radiation therapy.
- Higher radiation doses did not correlate with improved control but were associated with Grade 3 complications above 60 Gy.
Conclusions:
- Radiation therapy is an effective treatment for desmoid tumors, particularly for unresectable or residual disease.
- Adjuvant radiotherapy demonstrates a high probability of local control, influenced by the number of prior surgical procedures.
- Careful dose selection is crucial to balance efficacy and minimize severe complications.