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The Desmoid Tumor Research Foundation

July 2020

Effectiveness of doxorubicin-based and liposomal doxorubicin chemotherapies for patients with extra-abdominal desmoid-type fibromatosis: a systematic review

Author Information

Shimizu K(1), Kawashima H(2), Kawai A(3), Yoshida M(4,5), Nishida Y(1,6).

(1)Dept of Orthopedic Surgery, Nagoya Univ Graduate School of Medicine, Nagoya, Japan. (2)Dept of Orthopedic Surgery, Niigata Univ Graduate School of Medical and Dental Sciences, Niigata, Japan. (3)Dept of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan. (4)Dept of Hemodialysis and Surgery, Ichikawa Hospital, International Univ of Health and Welfare, Otawara, Japan. (5)Dept of EBM and Guidelines, Japan Council for Quality Health Care, Tokyo, Japan. (6)Dept of Rehabilitation Medicine, Nagoya Univ Hospital, Nagoya, Japan.

Publication

Jpn J Clin Oncol

Summary

The guideline committee for clinical care of extra-abdominal desmoid-type fibromatosis in Japan conducted a systematic review of treatment with doxorubicin-based chemotherapy for desmoid-type fibromatosis. We searched the pertinent literature. Two reviewers evaluated and screened it independently for eligibility and extracted data. They rated each report according to the grading of recommendations development and evaluation methodology. Based on the 'body of evidence', which the reviewers created, the clinical guideline committee decided a recommendation for the clinical question, 'Is doxorubicin-based chemotherapy effective for patients with extra-abdominal desmoid-type fibromatosis? Fifty-three articles were extracted by the literature search, and one from hand search. After the first and second screenings, five articles were subjected to the final evaluation. There were no randomized controlled trials. According to response evaluation criteria in solid tumors criteria, the response rates of doxorubicin-based regimens and liposomal doxorubicin were 44% (28.6-54) and 33.3% (0-75) on average, respectively. In two reports, the response rates of doxorubicin-based regimens were higher than those of non-doxorubicin-based ones; 54% vs 12%, 40% vs 11%, respectively. The rates of G3 or G4 complications according to common terminology criteria for adverse events were 28% and 13% with doxorubicin-based and liposomal doxorubicin chemotherapy, respectively, including neutropenia or cardiac dysfunction. None of the reports addressed the issue of QOL. Although the evidence level was low in the evaluated studies, doxorubicin-based and liposomal doxorubicin chemotherapy was observed to be effective. However, doxorubicin-based chemotherapy is associated with non-ignorable adverse events, and is not covered by insurance in Japan. We weakly recommend doxorubicin-based chemotherapy for patients with extra-abdominal desmoid-type fibromatosis in cases resistant to other treatments.

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