Hoffmann W, Weidmann B, Schmidberger H, Niederle N, Seeber S, Bamberg M
Abteilung für Strahlentherapie, Eberhard-Karls-Universität Tübingen.
Strahlenther Onkol. 1993 Apr;169(4):235-41.
Desmoid tumors are accounted among histologically benign soft tissue tumors. Though metastases do not occur the clinical course of the disease with their tendency to grow locally aggressive and to relapse after curative intended surgery is similar to sarcomas. After surgical excision adjuvant therapy of desmoid tumors is necessary in such cases, where a radical excision with a wide margin is not possible, or must be doubted or after the surgical excision of a locally recurrent tumor. Radiation doses of 50 to 60 Gy reduce the risk of local recurrence of desmoid tumors to 18%. In such cases, where surgery and radiotherapy have been leading to incomplete responses, systemic therapy with hormones (tamoxifen or progesterone), with alkylating agents (e. g. ifosfamide) or with prostaglandin antagonists (indomethacin) is possible. The published data on therapeutic responses to the treatment of desmoid tumors are scarce. We are reporting on seven of our own cases, treated with surgery and radiotherapy (four) or with a combination of surgery, radiotherapy, hormones and chemotherapy (three).
韧带样瘤属于组织学上良性的软组织肿瘤。虽然不会发生转移，但该疾病的临床病程具有局部侵袭性生长的倾向，且在进行根治性手术切除后容易复发，这与肉瘤相似。在手术切除后，对于那些无法进行广泛切缘的根治性切除、或对此存在疑问的情况，以及在手术切除局部复发性肿瘤后，韧带样瘤都需要进行辅助治疗。50至60Gy的放射剂量可将韧带样瘤的局部复发风险降低至18%。在手术和放疗导致反应不完全的情况下，可以采用激素（他莫昔芬或孕酮）、烷化剂（如异环磷酰胺）或前列腺素拮抗剂（吲哚美辛）进行全身治疗。关于韧带样瘤治疗反应的已发表数据很少。我们报告了我们自己治疗的7例病例，其中4例采用手术和放疗，3例采用手术、放疗、激素和化疗联合治疗。
