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Clinical outcomes of systemic therapy for patients with deep fibromatosis (desmoid tumor)
Author(s) -
de Camargo Veridiana Pires,
Keohan Mary L.,
D'Adamo David R.,
Antonescu Cristina R.,
Brennan Murray F.,
Singer Samuel,
Ahn Linda S.,
Maki Robert G.
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25089
Subject(s) - medicine , dacarbazine , fibromatosis , systemic therapy , anthracycline , aggressive fibromatosis , radiation therapy , oncology , hormonal therapy , response evaluation criteria in solid tumors , chemotherapy , tamoxifen , sarcoma , imatinib , surgery , disease , progressive disease , cancer , breast cancer , pathology , myeloid leukemia
Abstract BACKGROUND: In the current study, the authors examined the outcomes of patients with desmoid tumors who received systemic therapy at a single institution to provide a basis for the examination of newer agents. METHODS: Records of patients with desmoid tumors who were treated with chemotherapy at the study institution were reviewed. The activity of nonsteroidal anti–inflammatory drugs was not addressed. Patients without measurable disease and those receiving therapy could not be documented, and those receiving prophylactic therapy were excluded. RESULTS: A total of 68 patients received 157 lines of therapy. At the time of last follow–up, 9 patients had died, 7 of progressive disease. The cohort was 62% female, with a median age of 32.5 years. Approximately 32% of the patients had Gardner syndrome. The median follow‐up was 63 months, and patients received a median of 2 lines of therapy. An intra‐abdominal primary tumor location was the most common (44%). The greatest Response Evaluation Criteria in Solid Tumors (RECIST) response rate was observed with anthracyclines and hormonal therapy and the lowest response was noted with single‐agent dacarbazine/temozolomide or tyrosine kinase inhibitors, principally imatinib. On multivariate analysis, macroscopic nodular morphology and the presence of Gardner syndrome were the only tumor factors found to be associated with a greater time to disease progression. CONCLUSIONS: Compared with other agents, antiestrogens and anthracycline‐containing regimens appear to be associated with a higher radiological response rate against desmoid tumors. Systemic therapy can be successful in patients with desmoid tumors, and is a viable option in lieu of morbid or disabling surgery. Cancer 2010. © 2010 American Cancer Society.