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The Desmoid Tumor Research Foundation

March 2020

Definitive radiation therapy in patients with unresectable desmoid tumors: a systematic review

Author Information

Matsunobu T(1), Kunisada T(2), Ozaki T(3), Iwamoto Y(1), Yoshida M(4)(5), Nishida Y(6)(7).

(1)Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Japan. (2)Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. (3)Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. (4)Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan. (5)Department of EBM and Guidelines, Japan Council for Quality Health Care, Tokyo, Japan. (6)Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. (7)Department of Rehabilitation Medicine, Nagoya University Hospital, Nagoya, Japan.

Publication

Jpn J Clin Oncol

Summary

The aim of this systematic review was to evaluate the effect of radiation therapy on patients with desmoid tumors, especially those with unresectable disease. We evaluated studies published between 1 January 1990 and 31 August 2017 and cited in PubMed and Ichushi (in Japanese). All studies evaluating the effect of radiation therapy on desmoid tumors were included. Among 218 identified studies, only 6 were finally included in this review. Local control was achieved in 253 of 317 patients with unresectable or unresected tumors who underwent definitive radiation therapy (the crude rate of local control was 79.8%). Toxicity was evaluated in patients who underwent definitive radiation therapy or surgery plus radiation therapy. One of the most common acute complications was skin toxicity. Frequent late complications of radiation therapy included fibrosis/contracture/joint stiffness, skin disorders, lymphedema and pain. Six patients developed secondary malignancies in the radiation field. In patients treated unsuccessfully with surgery, watchful waiting and pharmacotherapy, radiation therapy may be an option as salvage therapy because of the high rate of local control. Because desmoid tumors frequently develop in young individuals, children and young patients who receive radiation therapy for the treatment of desmoid tumors should be followed up on a long-term basis with periodic monitoring for late radiation toxicities.

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