Goy B W, Lee S P, Fu Y S, Selch M T, Eilber F
Department of Radiation Oncology, Daniel Freeman Memorial Hospital, Inglewood, California 90301, USA.
Am J Clin Oncol. 1998 Dec;21(6):584-90. doi: 10.1097/00000421-199812000-00011.
The authors compare the progression-free survival of patients with unresected or partially resected desmoid tumors treated with radiotherapy with those not given radiotherapy. A retrospective analysis and pathologic review was performed on 14 patients treated at the University of California Los Angeles School of Medicine from 1965 through 1992. Median follow-up was 6 years. The 6-year progression-free survival for irradiated patients was 100%, compared with 50% for those not irradiated (p = 0.04). Of the seven patients irradiated, only two had a complete response and one had a partial response. There was no difference in disease-specific survival between patients irradiated and those not irradiated, because only 1 of 14 patients died of desmoid tumor progression, which caused airway obstruction. This data suggest that radiotherapy may improve the progression-free survival of patients with unresected or partially resected desmoid tumor; however, the number of patients in this series is small. Most patients did not have a complete response to radiotherapy. For patients with tumor adjacent to the airway in the neck or upper thorax, the authors recommend radiotherapy because of the potential for mortality. Otherwise, because tumor progression rarely causes death, one must consider whether the morbidity of treatment would outweigh the morbidity of disease progression.
作者比较了接受放疗与未接受放疗的未切除或部分切除的硬纤维瘤患者的无进展生存期。对1965年至1992年在加利福尼亚大学洛杉矶分校医学院接受治疗的14例患者进行了回顾性分析和病理检查。中位随访时间为6年。接受放疗患者的6年无进展生存率为100%，未接受放疗患者为50%（p = 0.04）。在接受放疗的7例患者中，仅2例完全缓解，1例部分缓解。接受放疗与未接受放疗的患者之间疾病特异性生存率无差异，因为14例患者中仅1例死于硬纤维瘤进展导致的气道阻塞。该数据表明放疗可能改善未切除或部分切除的硬纤维瘤患者的无进展生存期；然而，本系列中的患者数量较少。大多数患者对放疗没有完全缓解。对于肿瘤位于颈部或上胸部气道附近的患者，由于存在死亡风险，作者建议进行放疗。否则，由于肿瘤进展很少导致死亡，必须考虑治疗的发病率是否会超过疾病进展的发病率。
