Extended follow-up of patients treated with cytotoxic chemotherapy for intra-abdominal desmoid tumors

BACKGROUND: Cytotoxic chemotherapy can achieve a good initial response in i noperable desmoid tumors that have caused progressive obstruction of the ga strointestinal and urinary tracts and have caused unrelenting pain. METHODS : We have reviewed 8 patients (3 male) with desmoid tumors and familial ade nomatous polyposis who underwent cytotoxic chemotherapy for inoperable gast rointestinal obstruction and/or uncontrolled pain. They were treated with d oxorubicin and dacarbazine followed by carboplatin and dacarbazine. RESULTS : Follow-up after cytotoxic chemotherapy in the 7 patients for whom it was available was a mean of 42 (range 24-54) months. Two patients achieved comp lete remission after therapy. Four patients achieved a partial remission af ter completing all or some of the chemotherapy regimen; of these, three rem ained in stable remission, whereas the other was lost to follow-up. There w ere two recurrences that required further therapy; one of these patients wa s treated with further chemotherapy, which induced a second remission, and the other was treated with pelvic exenteration and has subsequently died. C ONCLUSIONS: Most patients had a substantial response to cytotoxic chemother apy; however, two patients required additional therapy 24 and 30 months aft er cytotoxic chemotherapy, respectively. Cytotoxic chemotherapy is effectiv e in producing short-term and long-term remission in these difficult patien ts.