Radiotherapy in the treatment of primary or recurrent unresectable desmoid tumors of the neck

Abstract

Purpose: Desmoid tumors are locally aggressive nonmalignant soft tissue tumors, which frequently recur after therapy. The optimal treatment is still controversial because of the lack of large research. A few studies have reported the effects of other treatments in one lesion when surgery is not possible or would cause notable functional impairment. Our aim was to examine the outcome of radiotherapy (RT) in the treatment of primary or recurrent unresectable desmoid tumors of the neck.

Materials: A retrospective analysis was performed on 30 patients between 1/2008 and 12/2017, with 3 primary and 27 recurrent unresectable desmoid tumors of the neck. All cases were reviewed by pathologists.

Results: The median follow-up time was 50.5 months (range 2–126 months). Radiotherapy doses varied from 50 to 66 Gy (median 60 Gy, 23/30 patients) with all fraction size of 2 Gy. The objective response rate (ORR: CR or PR) to definitive RT was 56.7% (17/30 patients). On Chi-square statistic, ORR was significantly influenced by tumor size (≤5 cm versus >5 cm) (p = .046). Age (≤ 40 versus >40 years) (p = .804), gender (p = .629), and RT dose (≤60 versus >60 Gy) (p = .613) were not significantly associated with ORR. The most common acute side effects of the radiation-related complication were grade 1–2 skin toxicities.

Conclusion: Radiotherapy is a valuable option in the management of primary or recurrent unresectable DTs of the neck with good local control. Multi-institutional and prospective studies are warranted to further validate our findings.

Keywords:

• Radiotherapy
• desmoid tumors
• neck
• benign neoplasms
• unresectable

Declaration of interest

The abstract of this paper was presented at the ASTRO Conference name ‘Radiation Therapy in the Treatment of Primary or Recurrent Unresectable Desmoid Tumors of the Neck’ as a poster presentation with interim findings. The poster’s abstract was published in ‘Poster Abstracts’ in International Journal of Radiation Oncology • Biology • Physics name ‘Radiation Therapy in the Treatment of Primary or Recurrent Unresectable Desmoid Tumors of the Neck’: Hyperlink with https://doi.org/10.1016/j.ijrobp.2018.07.1264.