A systematic review of active treatment options in patients with desmoid tumours

作者：Yao X; Corbett T; Gupta A A; Kandel R A; Verma S; Werier J; Ghert M^*

来源：Current Oncology, 2014, 21(4): E613-E629.

DOI：10.3747/co.21.1995

• Desmoid tumours
• systematic review
• treatments

Introduction
We conducted a systematic review to determine the optimal treatment options in patients with desmoid tumours who have declined observational management.
Methods
A search was conducted of the MEDLINE and EMBASE databases (1990 to September 2012), the Cochrane Library, and relevant guideline Web sites and conference materials.
Results
One systematic review and forty-six studies met the preplanned study selection criteria; data from twenty-eight articles were extracted and analyzed. For local control, three studies reported a statistically significant difference in favour of surgery plus radiotherapy (RT) compared with surgery alone, and one study did not; two studies reported the lack of a statistical difference between surgery plus RT and RT alone in maintaining local control. Multivariate risk factors for local recurrence included positive surgical margins and young patient age. Single-agent imatinib led to a progression-free survival rate of 55% at 2 years and 58% at 3 years. Methotrexate plus vinblastine led to a progression-free survival rate of 67% at 10 years. Significant toxicities were reported for all treatment modalities, including surgical morbidity, and RT- and chemotherapy-related toxicities.
Conclusions
In patients who have declined observational management, the local control rate was higher with surgery plus RT than with surgery alone. However, the additional RT-related complications should be considered in treatment decision-making. Surgery, RT, and systemic therapy are all reasonable treatment options for patients with desmoid tumours.

• 出版日期2014-8