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KMID : 0859320070250040201
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Journal of the Korean Society for Therapeutic Radiology and Oncology
2007 Volume.25 No. 4 p.201 ~ p.205
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The Necessity of Early Adjuvant Radiotherapy for Better Outcomes in the Treatment of a Desmoid Tumor
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Lee Me-Yeon
Chang Ah-Ram
Kim Hak-Jae
Kim Kyu-Bo
Kim Jin-Ho
Park Chan-Il
Ha Sung-Whan
Wu Hong-Gyun
Kim Il-Han
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Abstract
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Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in
patients with a desmoid tumor treated with postoperative radiotherapy.
Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative
radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients.
The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an
extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25
cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial
surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given
was 45∼66 Gy (median dose, 59.4 Gy), and the fraction size was 1.8∼2.0 Gy.
Results: The median follow-up period was 61 months (range, 12∼203 months). Two patients developed local
progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year
progression-free survival rate were 61% and 70%, respectively. Wide local excision was associated with better
disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a
higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with
statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in
patients that received radiotherapy after reoperation (p＜0.001).
Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of
subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients
with a high risk of recurrence for a desmoid tumor
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KEYWORD
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Desmoid tumor, Radiotherapy
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