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• Montgomery, C
• Emory, C
• Adams, S
• Cohen, J
• Pitcher, J
• Potter, B
• Temple, H
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• Montgomery, C
• Emory, C
• Adams, S
• Cohen, J
• Pitcher, J
• Potter, B
• Temple, H
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• Montgomery, C
• Emory, C
• Adams, S
• Cohen, J
• Pitcher, J
• Potter, B
• Temple, H

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Cancers 2011, 3(3), 3394-3404; doi:10.3390/cancers3033394

Article

Treatment of Extra — Abdominal Desmoid Tumors with Chemotherapy

Corey Montgomery ¹ , Cynthia Emory ² , Sheila Adams ³ , Jonathan Cohen ⁴ , John David Pitcher ⁵ , Benjamin Kyle Potter ⁶  and H. Thomas Temple ^7,*

¹ Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72211, USA ² Wake Forest School of Medicine, Medical Center Blvds, Winston-Salem, NC 27157, USA ³ Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Cedars Medical Center, 1400 NW 12th Avenue (R-12), Miami, FL 33136, USA ⁴ Division of Psychology, University of Miami Miller School of Medicine, 1695 N.W. 9th Ave. (D-29), Miami, FL 33136, USA ⁵ Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, 1400 NW 12th Avenue (R-12), Miami, FL 33136, USA ⁶ Department of Orthopaedic Surgery, Walter Reed Army Medical Center, 6900 Georgia Avenue North West, Washington, D.C., 20307, USA ⁷ Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, 1600 N.W. 10th Avenue (R-12), Miami, FL 33136, USA

* Author to whom correspondence should be addressed.

Received: 15 August 2011 / Accepted: 18 August 2011 / Published: 25 August 2011

(This article belongs to the Special Issue Desmoid Tumors)

Download PDF Full-Text [202 KB, uploaded 25 August 2011 15:52 CEST]

Abstract: Fibromatosis, or extra-abdominal desmoid tumor, is a benign disease which often has an aggressive clinical course that can be difficult to treat. We performed a retrospective review of 16 patients (12 females and four males) with a mean age of 34.2 years treated with methotrexate and vinblastine for newly diagnosed or recurrent extra-abdominal desmoid tumor. The mean age of our patient cohort was 34.2 years (range 11–70), and the mean tumor size was 11.5 cm (range 2.5–21.2 cm). The mean duration of therapy was 12 months with an average follow-up of 43 months (range 1–149 months). Fourteen of 16 patients demonstrated a clinical response to treatment. Eight of 14 patients demonstrated a radiologic decrease in tumor size. Only one patient progressed on therapy. Six patients developed recurrent symptoms after discontinuation of treatment. Chemotherapy-related symptoms including neutropenia, nausea, and vomiting were common and observed in most patients, however these side effects were mild and transient. Five patients developed peripheral neuropathy that prompted a change from vinblastine to vinorelbine during treatment. One potentially life-threatening complication (pneumocystis pneumonia) occurred which was diagnosed early and successfully treated. The use of methotrexate and vinblastine/vinorelbine in the management of fibromatosis appears to be an effective treatment with minimal treatment-related side effects.

Keywords: fibromatosis; desmoid tumors; chemotherapy; methotrexate; vinblastine; vinorelbine

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