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Onco Targets Ther. 2019 Mar 7;12:1741-1748. doi: 10.2147/OTT.S189449. eCollection 2019.

Single institution experience of split course radiotherapy in patients with desmoid tumors.

Luo J1,2, Jin K1,2, Qian S1,2, Ma X1,2, Pan Z1,2, Yao W1,2, Zhang Z1,2, Guo X1,2, Yu X1,2.

Author information

1
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China, stephanieyxl@hotmail.com; guoxm1800@163.com.
2
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, stephanieyxl@hotmail.com; guoxm1800@163.com.

Abstract

Purpose:

This study aimed to assess the feasibility of split course radiotherapy (SCRT) and reports long-term outcomes in patients with desmoid tumors (DT).

Patients and methods:

Between 2001 and 2004, 31 patients with recurrent (n=19) or primary large desmoid fibromatosis (≥10 cm) (n=12) who were treated with SCRT were retrospectively analyzed. All patients were treated with two phases of radiotherapy with a median interval time of 99 days (range: 81-122 days) and a median total dose of 6,399 cGy (range: 5,013-7,039 cGy). The median dose for the first phase was 3,969 cGy/22 Fx (range: 2,999-4,305 cGy), and 2,495 cGy/14 Fx (range: 1,982-3,039 cGy) for the second phase. Progression-free survival (PFS) in response to radiotherapy was evaluated using the Kaplan-Meier method and compared using the log-rank test. The prognostic factors associated with survival were evaluated by univariate and multivariate analyses.

Results:

The median age of all patients was 30 years (range, 7-58 years). With a median follow-up of 60.4 months (range, 2-187 months), eight patients experienced disease progression after treatment. The PFS rate at 3 and 5 years for the whole population was 90% and 71.3%, respectively. PFS for patients with split course of <100 days or ≥100 days interval was 100% vs 78.6% at 3 years, and 80.4% vs 62.9% at 5 years, respectively (P=0.189). In multivariate analysis, the radiotherapy (RT) interval time was an independent prognostic factor for PFS (≥100 days vs <100 days, HR 11.544, 95% CI 1.034-128.878, P=0.047). PFS was not significantly influenced by age, gender, surgery, tumor location, RT technology, or RT dose. Radiation-related acute complications occurred in nine (29%) patients after RT, and RT-related long-term complications occurred in three (9.7%) patients.

Conclusion:

SCRT with an appropriate treatment interval (<100 days) is well tolerated by DT patients with favorable long-term outcomes.

KEYWORDS:

desmoid tumors; local control; split course radiation

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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