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The Desmoid Tumor Research Foundation

April 2020

Efficacy of low-dose chemotherapy with methotrexate and vinblastine for patients with extra-abdominal desmoid-type fibromatosis: a systematic review

Author Information

Shimizu K(1), Hamada S(2), Sakai T(1), Koike H(1), Yoshida M(3)(4), Nishida Y(1)(5).

(1)Dept of Orthopedic Surg, Nagoya Univ Graduate School of Medicine, Nagoya, JPN. (2)Dept of Orthopedic Surg, Aichi Cancer Ctr Hosp, Nagoya, JPN. (3)Dept of Hemodialysis & Surg, Ichikawa Hosp, International Univ of Health & Welfare, Chiba, JPN. (4)Dept of EBM & Guidelines, JPN Council for Quality Health Care, Tokyo, JPN. (5)Dept of Rehabilitation, Nagoya Univ Hosp, Nagoya, JPN.

Publication

Jpn J Clin Oncol

Summary

This systematic review aims to evaluate the efficacy of low-dose chemotherapy with methotrexate and vinblastine for patients with extra-abdominal desmoid-type fibromatosis. We searched the pertinent literature from January 1990 to August 2017. The search yielded 40 studies, 9 of which were included after the first and second screenings. There were three prospective case series but no randomized controlled trials among the nine studies. There was no case-control report (vs. no treatment). According to Response Evaluation Criteria in Solid Tumors criteria, the mean response rate (complete remission or partial response) was 36% (11-57%). Including stable disease, namely, clinical benefit was consistently as high as 85% (69-100%). Mean adverse event rate of G3 or G4 according to CTCAE was 31%. One study reported improvement of pain (87.5%) because of this chemotherapy. The efficacy of this chemotherapy was convincing. However, the overall evidence was weak, and this chemotherapy is not covered by insurance in Japan; we only weakly recommend low-dose chemotherapy with methotrexate and vinblastine in patients with extra-abdominal desmoid-type fibromatosis.

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