RADIOTHERAPY FOR LOCAL-CONTROL OF AGGRESSIVE FIBROMATOSIS

Purpose: To evaluate local control rates in patients treated with radi otherapy for aggressive fibromatosis. Methods and Materials: Fifty-thr ee patients with histologically confirmed aggressive fibromatosis were treated with radiotherapy at the University of Florida between March 1975 and June 1992. The minimum length of follow-up was 2 years; 81% o f the patients had follow-up for at least 5 years, The lesions arose i n an extremity or limb girdle (39 patients), the trunk (10 patients), or the head and neck area (4 patients), Twenty-four patients were trea ted for gross disease and 29 for presumed microscopic residual disease after one or more operations. Patients were treated with total doses between 35 and 70 Gy; 83% of patients received 50 to 60 Gy. Results: L ocal control was achieved in 23 of 29 patients (79%) treated postopera tively for microscopic residual disease and in 21 of 24 patients (88%) treated for gross disease; gross disease was controlled in all 8 pati ents with previously untreated lesions and in 13 of 16 patients treate d postoperatively for gross residual or recurrent disease, Overall, ag gressive fibromatosis was locally controlled in 83% of treated patient s, All nine treatment failures occurred in patients with extremity les ions 4 to 68 months after initiation of treatment, Three recurrences w ere in the irradiated field, two were out of the field, and four were at the field margin, Eight patients were salvaged with surgery alone o r combined with postoperative radiotherapy, A functional limb was main tained in 38 of 39 patients with extremity or Limb girdle lesions, Pat hologic fracture occurred in three patients; two patients required rod fixation for treatment. Conclusions: Radiotherapy is a valuable adjun ct to surgery in the management of aggressive fibromatosis and can be used alone in patients with unresectable or inoperable disease. Copyri ght (C) 1996 Elsevier Science Inc.