CHEMOTHERAPY OF JUVENILE ANGIOFIBROMAS - AN ALTERNATIVE COURSE FOR TREATMENT

Since February 1979, 22 juvenile angiofibromas have been treated among 312 tumors of the skull base managed in the ENT Department, Fulda. Ac cording to a general staff consensus the treatment of choice was compl ete surgical removal. This was achieved in 20 cases with one operation and in one case with two operations. In addition to removal of tumor, functional and aesthetic aspects had to be considered as aims of oper ative treatment, including among others preservation of the facial ske leton, infraorbital nerve, nasolacrimal drainage system and vision. In rare cases complete excision of the tumor is not possible. The value of cytostatic therapy is demonstrated in one patient with uncommonly a dvanced disease. Considering the extensive regression of tumor achieve d in this case after chemotherapy with Adriamycin and decarbazine, one has to raise the question if the chemotherapeutic approach was more t han just palliative. From our experience chemotherapy should be consid ered a possible alternative to radiation in the management of unresect able juvenile angiofibromas.