Moding Everett J, Million Lynn, Avedian Raffi, Ghanouni Pejman, Kunder Christian, Ganjoo Kristen N
Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Sarcoma. 2017;2017:2316839. doi: 10.1155/2017/2316839. Epub 2017 Jul 5.
Desmoid tumors are locally aggressive fibroproliferative neoplasms that can lead to pain and dysfunction due to compression of nerves and surrounding structures. Desmoid tumors often progress through medical therapy, and there is frequently a delay of multiple months before radiation can provide symptomatic relief. To achieve more rapid symptomatic relief and tumor regression for unresectable desmoid tumors causing significant morbidity such as brachial plexus impingement with loss of extremity function, we have selectively utilized a combination of imatinib and radiation therapy. Here, we retrospectively review four patients treated with concurrent imatinib and radiation therapy. The treatment was typically tolerated with minimal toxicity though one patient developed avascular necrosis of the irradiated humeral head possibly related to the combined treatment. All the patients treated have had a partial response or stable disease on imaging. Improvement of symptoms was observed in all the treated patients with a median time to relief of 2.5 months after starting radiation therapy. Concurrent radiation and imatinib may represent a viable treatment option for unresectable and symptomatic desmoid tumors where rapid relief is needed to prevent permanent loss of function.
硬纤维瘤是局部侵袭性纤维增生性肿瘤，可因压迫神经和周围结构而导致疼痛和功能障碍。硬纤维瘤常通过药物治疗进展，在放疗能提供症状缓解之前，通常会有几个月的延迟。为了使导致严重发病（如臂丛神经受压伴肢体功能丧失）的不可切除硬纤维瘤更快地获得症状缓解和肿瘤消退，我们选择性地使用了伊马替尼和放疗的联合治疗。在此，我们回顾性分析了4例接受伊马替尼和放疗联合治疗的患者。该治疗通常耐受性良好，毒性极小，不过有1例患者发生了照射肱骨头的缺血性坏死，可能与联合治疗有关。所有接受治疗的患者在影像学上均有部分缓解或病情稳定。所有接受治疗的患者症状均有改善，开始放疗后症状缓解的中位时间为2.5个月。对于需要快速缓解以防止永久性功能丧失的不可切除且有症状的硬纤维瘤，放疗与伊马替尼联合治疗可能是一种可行的治疗选择。
