Kamath S S, Parsons J T, Marcus R B, Zlotecki R A, Scarborough M T
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, USA.
Int J Radiat Oncol Biol Phys. 1996 Sep 1;36(2):325-8. doi: 10.1016/s0360-3016(96)00321-5.
To evaluate local control rates in patients treated with radiotherapy for aggressive fibromatosis.
Fifty-three patients with histologically confirmed aggressive fibromatosis were treated with radiotherapy at the University of Florida between march 1975 and June 1992. The minimum length of follow-up was 2 years; 81% of the patients had follow-up for at least 5 years. The lesions arose in an extremity or limb girdle (39 patients), the trunk (10 patients), or the head and neck area (4 patients). Twenty-four patients were treated for gross disease and 29 for presumed microscopic residual disease after one or more operations. Patients were treated with total doses between 35 and 70 Gy; 83% of patients received 50 to 60 Gy.
Local control was achieved in 23 of 29 patients (79%) treated postoperatively for microscopic residual disease and in 21 of 24 patients (88%) treated for gross disease; gross disease was controlled in all 8 patients with previously untreated lesions and in 13 of 16 patients treated postoperatively for gross residual or recurrent disease. Overall, aggressive fibromatosis was locally controlled in 83% of treated patients. All nine treatment failures occurred in patients with extremity lesions 4 to 68 months after initiation of treatment. Three recurrences were in the irradiated field, two were out of the field, and four were at the field margin. Eight patients were salvaged with surgery alone or combined with postoperative radiotherapy. A functional limb was maintained in 38 of 39 patients with extremity or limb girdle lesions. Pathologic fracture occurred in three patients; two patients required rod fixation for treatment.
Radiotherapy is a valuable adjunct to surgery in the management of aggressive fibromatosis and can be used alone in patients with unresectable or inoperable disease.
评估接受放射治疗的侵袭性纤维瘤病患者的局部控制率。
1975年3月至1992年6月期间，佛罗里达大学对53例经组织学确诊为侵袭性纤维瘤病的患者进行了放射治疗。随访最短时间为2年；81%的患者随访至少5年。病变发生在四肢或肢体带（39例患者）、躯干（10例患者）或头颈部区域（4例患者）。24例患者因肉眼可见的疾病接受治疗，29例患者在一次或多次手术后因推测的微小残留疾病接受治疗。患者接受的总剂量在35至70 Gy之间；83%的患者接受了50至60 Gy的剂量。
29例术后接受微小残留疾病治疗的患者中有23例（79%）实现了局部控制，24例因肉眼可见疾病接受治疗的患者中有21例（88%）实现了局部控制；所有8例先前未治疗病变的患者以及16例术后因肉眼残留或复发性疾病接受治疗的患者中有13例实现了肉眼可见疾病的控制。总体而言，83%的接受治疗的患者侵袭性纤维瘤病得到了局部控制。所有9例治疗失败均发生在四肢病变患者中，治疗开始后4至68个月出现。3例复发发生在照射野内，2例在照射野外，4例在野边缘。8例患者通过单独手术或联合术后放疗得到挽救。39例四肢或肢体带病变患者中有38例保留了功能肢体。3例患者发生了病理性骨折；2例患者需要用棒固定进行治疗。
放射治疗是侵袭性纤维瘤病治疗中手术的重要辅助手段，对于不可切除或无法手术的疾病患者可单独使用。
