Lay Abstract
The present study is focused on evaluating the efficacy and safety of doxorubicin eluting
embolization (DEE) as a local therapy for Desmoid Fibromatosis (DF). DEE is
a technique that delivers doxorubicin to the tumor via micro partiles, minimizing
systemic toxicity. The study aims to build on previous reports of successful outcomes
of DEE in DF patients by standardizing the treatment protocol and evaluatng its
efficacy in a larger cohort of patients. The study also aims to address the limita.ons
in making DEE accessible to more patients, including the paucity of interventional
radiologists reporting on the technique and unfamiliarity of the technique among
referring clinicians. The study is designed to maximize the multidisciplinary
contributions of medical oncologists, surgeons, and interventional
radiologists from leading tertiary sarcoma centers to facilitate safe adoption of this
technique among practitioners.
Scientific Abstract
Doxorubicin is an effective treatment for Desmoid Fibromatosis but its use is limited
by systemic toxicity. Selective arterial Doxorubicin Eluting Embolization (DEE) can
be employed to achieve a high doxorubicin concentra.on in the target tissue while
maintaining low systemic exposure. In this technique, biocompatible microparticles
loaded with doxorubicin are released via catheter navigation into blood vessels that
supply desmoid tumors. These particles, which are typically 100-300 uM in diameter,
lodge within (embolize) the small arteries within a tumor and allow the doxorubicin to
penetrate via elution. We initially described this technique in a pediatric case series
in 2018 and in 2022 reported on a larger series of 24 patients treated with 52 DEE
sessions. The purpose of this study is to establish procedural, technical guidelines
for practicing interven.onal radiologists and for referring physicians to understand
which patients are potential candidates for DEE vs the other growing armamentarium
of systemic therapies and cryoablation.