Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results

Seo Hee Choi, Hong In Yoon, Seung Hyun Kim, Sang Kyum Kim, Kyoo Ho Shin, Chang-Ok Suh

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose Although locally invasive or recurrent fibromatosis is primarily treated with surgery, radiotherapy (RT) produces local control for recurrent/unresectable tumors or those with positive surgical margins. Herein, we describe our updated institutional experience with RT to treat fibromatosis. Methods Forty-seven patients with fibromatosis received RT between 1990 and 2015, and were followed for 12 months. Eight patients received RT for gross tumors, and 39 received postoperative RT after single/multiple prior surgeries. A median dose of 54 Gy was prescribed for definitive RT; 48.6, 50.4, and 54 Gy were prescribed for R0, R1, and R2 resected tumors, respectively. Recurrences were classified as in-field, marginal, or out-field. Prognostic factors were also evaluated. Results Seven recurrences were noted, including 2 in-field, 4 marginal, and 1 out-field, after a median follow-up of 60 months. In-field recurrences occurred in 1 patient who received 40.5 Gy of salvage RT after postoperative recurrence and another who received 45 Gy for R1 resection after multiple prior operations. All marginal failures were due to insufficient clinical target volume (CTV) margins regardless of dose (3 with 45 Gy and 1 with 54 Gy). On multivariate analysis, a CTV margin 5 cm and dose >45 Gy were significant predictors of non-recurrence (p = 0.039 and 0.049, respectively). Subgroup analysis showed that patients with both an CTV margin 5 cm and a dose >45 Gy showed a favorable outcome. Conclusions RT is a valuable option for treating aggressive fibromatosis; doses 45 Gy and a large field produce optimal results. For in-field control, a higher dose is more necessary for gross residual tumors than for totally excised lesions.

Original languageEnglish
Article numbere0198134
JournalPloS one
Volume13
Issue number5
DOIs
Publication statusPublished - 2018 May 1

Fingerprint

Fibroma
Radiotherapy
radiotherapy
Tumors
dosage
Recurrence
neoplasms
Surgery
surgery
Aggressive Fibromatosis
Salvaging
Neoplasms
Residual Neoplasm
resection
multivariate analysis
Dosimetry
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Choi, Seo Hee ; Yoon, Hong In ; Kim, Seung Hyun ; Kim, Sang Kyum ; Shin, Kyoo Ho ; Suh, Chang-Ok. / Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results. In: PloS one. 2018 ; Vol. 13, No. 5.
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abstract = "Purpose Although locally invasive or recurrent fibromatosis is primarily treated with surgery, radiotherapy (RT) produces local control for recurrent/unresectable tumors or those with positive surgical margins. Herein, we describe our updated institutional experience with RT to treat fibromatosis. Methods Forty-seven patients with fibromatosis received RT between 1990 and 2015, and were followed for 12 months. Eight patients received RT for gross tumors, and 39 received postoperative RT after single/multiple prior surgeries. A median dose of 54 Gy was prescribed for definitive RT; 48.6, 50.4, and 54 Gy were prescribed for R0, R1, and R2 resected tumors, respectively. Recurrences were classified as in-field, marginal, or out-field. Prognostic factors were also evaluated. Results Seven recurrences were noted, including 2 in-field, 4 marginal, and 1 out-field, after a median follow-up of 60 months. In-field recurrences occurred in 1 patient who received 40.5 Gy of salvage RT after postoperative recurrence and another who received 45 Gy for R1 resection after multiple prior operations. All marginal failures were due to insufficient clinical target volume (CTV) margins regardless of dose (3 with 45 Gy and 1 with 54 Gy). On multivariate analysis, a CTV margin 5 cm and dose >45 Gy were significant predictors of non-recurrence (p = 0.039 and 0.049, respectively). Subgroup analysis showed that patients with both an CTV margin 5 cm and a dose >45 Gy showed a favorable outcome. Conclusions RT is a valuable option for treating aggressive fibromatosis; doses 45 Gy and a large field produce optimal results. For in-field control, a higher dose is more necessary for gross residual tumors than for totally excised lesions.",
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Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results. / Choi, Seo Hee; Yoon, Hong In; Kim, Seung Hyun; Kim, Sang Kyum; Shin, Kyoo Ho; Suh, Chang-Ok.

In: PloS one, Vol. 13, No. 5, e0198134, 01.05.2018.

Research output: Contribution to journalArticle

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T1 - Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results

AU - Choi, Seo Hee

AU - Yoon, Hong In

AU - Kim, Seung Hyun

AU - Kim, Sang Kyum

AU - Shin, Kyoo Ho

AU - Suh, Chang-Ok

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N2 - Purpose Although locally invasive or recurrent fibromatosis is primarily treated with surgery, radiotherapy (RT) produces local control for recurrent/unresectable tumors or those with positive surgical margins. Herein, we describe our updated institutional experience with RT to treat fibromatosis. Methods Forty-seven patients with fibromatosis received RT between 1990 and 2015, and were followed for 12 months. Eight patients received RT for gross tumors, and 39 received postoperative RT after single/multiple prior surgeries. A median dose of 54 Gy was prescribed for definitive RT; 48.6, 50.4, and 54 Gy were prescribed for R0, R1, and R2 resected tumors, respectively. Recurrences were classified as in-field, marginal, or out-field. Prognostic factors were also evaluated. Results Seven recurrences were noted, including 2 in-field, 4 marginal, and 1 out-field, after a median follow-up of 60 months. In-field recurrences occurred in 1 patient who received 40.5 Gy of salvage RT after postoperative recurrence and another who received 45 Gy for R1 resection after multiple prior operations. All marginal failures were due to insufficient clinical target volume (CTV) margins regardless of dose (3 with 45 Gy and 1 with 54 Gy). On multivariate analysis, a CTV margin 5 cm and dose >45 Gy were significant predictors of non-recurrence (p = 0.039 and 0.049, respectively). Subgroup analysis showed that patients with both an CTV margin 5 cm and a dose >45 Gy showed a favorable outcome. Conclusions RT is a valuable option for treating aggressive fibromatosis; doses 45 Gy and a large field produce optimal results. For in-field control, a higher dose is more necessary for gross residual tumors than for totally excised lesions.

AB - Purpose Although locally invasive or recurrent fibromatosis is primarily treated with surgery, radiotherapy (RT) produces local control for recurrent/unresectable tumors or those with positive surgical margins. Herein, we describe our updated institutional experience with RT to treat fibromatosis. Methods Forty-seven patients with fibromatosis received RT between 1990 and 2015, and were followed for 12 months. Eight patients received RT for gross tumors, and 39 received postoperative RT after single/multiple prior surgeries. A median dose of 54 Gy was prescribed for definitive RT; 48.6, 50.4, and 54 Gy were prescribed for R0, R1, and R2 resected tumors, respectively. Recurrences were classified as in-field, marginal, or out-field. Prognostic factors were also evaluated. Results Seven recurrences were noted, including 2 in-field, 4 marginal, and 1 out-field, after a median follow-up of 60 months. In-field recurrences occurred in 1 patient who received 40.5 Gy of salvage RT after postoperative recurrence and another who received 45 Gy for R1 resection after multiple prior operations. All marginal failures were due to insufficient clinical target volume (CTV) margins regardless of dose (3 with 45 Gy and 1 with 54 Gy). On multivariate analysis, a CTV margin 5 cm and dose >45 Gy were significant predictors of non-recurrence (p = 0.039 and 0.049, respectively). Subgroup analysis showed that patients with both an CTV margin 5 cm and a dose >45 Gy showed a favorable outcome. Conclusions RT is a valuable option for treating aggressive fibromatosis; doses 45 Gy and a large field produce optimal results. For in-field control, a higher dose is more necessary for gross residual tumors than for totally excised lesions.

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