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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 4/2017

01-04-2017 | Original Article

Radiotherapy in desmoid tumors

Treatment response, local control, and analysis of local failures

Authors: Kirsi Santti, Annette Beule, Laura Tuomikoski, Mikko Rönty, Anna-Stina Jääskeläinen, Kauko Saarilahti, Hanna Ihalainen, Maija Tarkkanen, Carl Blomqvist

Published in: Strahlentherapie und Onkologie | Issue 4/2017

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Abstract

Background

Desmoid tumors (aggressive fibromatosis) are rare soft tissue tumors which frequently recur after surgery. Desmoid tumors arise from musculoaponeurotic tissue in the extremities, head and neck, abdominal wall, or intra-abdominally. Our aim was to examine the outcome of radiotherapy of desmoid tumors in a single institution series.

Patients and methods

We evaluated 41 patients with desmoid tumors treated with 49 radiotherapies between 1987 and 2012. Radiologic images for response evaluation were reassessed and responses to treatment registered according to RECIST criteria 1.1. For patients with local failures radiation dose distribution was determined in each local failure volume using image co-registration. Recurrences were classified as in-target, marginal, or out-of-target. Prognostic factors for radiotherapy treatment failure were evaluated.

Results

Radiotherapy doses varied from 20–63 Gy (median 50 Gy) with a median fraction size of 2 Gy. The objective response rate to definitive radiotherapy was 55% (12/22 patients). Median time to response was 14 months. A statistically significant dose-response relation for definitive and postoperative radiotherapy was observed both in univariate (p-value 0.002) and in multivariate analysis (p-value 0.02) adjusted for potential confounding factors. Surgery before radiotherapy or surgical margin had no significant effect on time to progression. Nine of 11 (82%) local failures were classified as marginal and two of 11 (18%) in-target. None of the recurrences occurred totally out-of-target.

Conclusions

Radiotherapy is a valuable option for treating desmoid tumors. Radiotherapy dose appears to be significantly associated to local control.
Appendix
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Metadata
Title
Radiotherapy in desmoid tumors
Treatment response, local control, and analysis of local failures
Authors
Kirsi Santti
Annette Beule
Laura Tuomikoski
Mikko Rönty
Anna-Stina Jääskeläinen
Kauko Saarilahti
Hanna Ihalainen
Maija Tarkkanen
Carl Blomqvist
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 4/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-016-1091-8

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