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RSNA: Radiotherapy Recommended for Management of Aggressive Fibromatosis By Peggy Peck Special to DG News CHICAGO, IL -- Nov. 28, 2001 -- Adjuvant or primary radiotherapy can significantly increase local tumor control in patients with aggressive fibromatosis. The finding was presented at the 87th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), in Chicago, Illinois. Dr. Oliver Micke of the University of Muenster, in Muenster, Germany, said that because aggressive fibromatosis is a rare condition with an incidence of 2-4/1,000,000 “it has been difficult to compile clinical data on efficacy of radiation treatment.” Typically, patients have numerous recurrences, which can lead to repeated "mutilating resections," he said. In his study, he combined findings from a series 26 patients, who were irradiated at his institution from 1980 to 2000, with an analysis of published studies. The Muenster patients, nine men and 17 women, all had histologically proven aggressive fibromatosis. The median age was 34 years and the median follow-up was 36 months. Twelve cases had desmoid tumors localized in the extremities, 12 at the thorax or shoulder and two at the abdominal wall, Dr. Micke said. Indications for radiotherapy included inoperable tumors and residual tumor. Postoperative radiation was administered at 50-55 Gy, while definitive radiation therapy dose was 60-65 Gy. Dr. Micke said earlier studies reported that doses of less than 40 Gy were not effective. Six of the patients developed a local relapse, so the long term local control rate was 77 percent. No patient died during follow-up and there were no acute or late toxicities, he said. The literature review yielded 69 articles, which evaluated more than 1,200 patients. The average local tumor control rate was 89 percent for post-operative radiotherapy and local control rate was 78 percent for primary radiotherapy. The local control rate with surgery alone was 45 percent. Dr. Micke concluded that treatment of aggressive fibromatosis should include radiotherapy. He also recommended the creation of an international database for the disorder. E-mail this page to a friend or colleague! To print, use this version