Desmoid tumor medical therapy
Desmoid tumor Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Faizan Sheraz, M.D. [3]
Overview
Medical therapy for desmoid tumor includes antiestrogens (ex. tamoxifen), NSAIDs, chemotherapy, or microwave ablation.
Medical Therapy
- Ideally, patients with desmoid tumors should be evaluated by a multi-disciplinary team which includes surgeons, medical oncologists, radiation oncologists, geneticists and nurses
- Patients with desmoid tumors should be evaluated in a hospital with expertise in sarcoma (usually such hospitals are designated as NCCN (National Comprehensive Cancer Network) centers)
- Wait and watch or observation of the tumor carefully with images and/or physical examination, is implied as a primary therapeutic option for desmoid tumors with following features:
- Potentially resectable but asymptomatic
- Non-life threatening
- Not causing any significant impairment
- Unresectable tumors
- Resectable but surgery would lead to unacceptable morbidity
- How often scans and/or physical exams are needed during a “wait and watch” period varies with each situation
- Treatment is recommended for extra-abdominal or abdominal desmoid tumors associated with:
- Symptoms
- Progressively enlarging tumors irrespective of symptoms
- Imminent risk to adjacent structures
- Tumor creating cosmetic concerns
- Goals of medical therapy are:
- Shrinkage of tumor size
- Stabilization of tumor
- Improvement in symptoms after a very wide variety of treatments
- Following table shows drugs used in medical therapy for desmoid tumors:[1][2]
Drug class | Drug name |
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Chemotherapeutic agents |
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NSAIDs |
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Anti-hormonal agents |
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Tyrosine kinase inhibitors |
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Radiation Therapy
- Rarely, radiation therapy is used if medical therapy and surgery fail
- Depending on the size and location of the tumor, radiation is delivered either in low doses over the course of 5 to 6 weeks or in a single high dose
- Radiation therapy is effective in approximately 30% of cases
Reference
- ↑ Wilkinson MJ, Fitzgerald JE, Thomas JM, Hayes AJ, Strauss DC (2012). "Surgical resection for non-familial adenomatous polyposis-related intra-abdominal fibromatosis". BJS. 99 (5): 706–13. doi:10.1002/bjs.8703. PMID 22359346.
- ↑ Rammohan A, Wood JJ (2012). "Desmoid tumour of the breast as a manifestation of Gardner's syndrome". Int J Surg Case Rep. 3 (5): 139–42. doi:10.1016/j.ijscr.2012.01.004. PMC 3312056. PMID 22370045.