Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Int J Radiat Oncol Biol Phys. 2009 Sep 1;75(1):177-82. doi: 10.1016/j.ijrobp.2008.10.072. Epub 2009 May 4.

Successful treatment of high risk and recurrent pediatric desmoids using radiation as a component of multimodality therapy.

Author information

  • 1Department of Radiation Oncology, University of California, San Francisco, CA, USA.

Abstract

PURPOSE:

To evaluate the role of radiation therapy (RT) as a component of multimodality therapy for pediatric desmoids.

METHODS AND MATERIALS:

Twenty-one children diagnosed between 1987 and 2005 were identified. Median age at start of treatment was 13 years (range, 2-21). Primary therapy consisted of resection alone (10), resection + external beam radiation therapy (EBRT) (5), resection + chemotherapy (CT; 3), EBRT alone (1), and CT alone (2).

RESULTS:

The median follow-up from start of treatment is 75.7 months (range, 16-162). Examining patients with gross total resections (GTRs) (-) margins and those who had GTRs (+) margins followed by EBRT, only 2 of 7 failed primary treatment. Conversely, 13 of 14 patients with other primary treatments failed locally. Of the 15 patients who recurred, only 1 patient had a GTR (-) margins. Seven of these patients had salvage therapy that did not include RT, and of these only 2 have no evidence of disease (NED) at last follow-up. In contrast, the remaining 8 patients received RT as a component of their final salvage therapy and 7 of these are NED at last follow-up. At last follow-up, no patient has died, although toxicities of therapy have occurred.

CONCLUSIONS:

Local control is difficult to achieve in pediatric patients with desmoids. In the setting in which negative surgical margins cannot be achieved, RT plays a key role in achieving NED status. Even after multiple recurrences, successful salvage is achievable, particularly when high-dose focal therapy is incorporated.

PMID:
19410386
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk