Radiation therapy for aggressive fibromatosis (desmoid tumors): Results of a national patterns of care study
Radiation therapy for aggressive fibromatosis (desmoid tumors): Results of a national patterns of care study
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DOI：
10.1016/j.ijrobp.2004.07.705
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发表时间：
2005-03-01
影响因子：
7
通讯作者：
Seegenschmiedt, MH
中科院分区：
文献类型：
--
作者：
Micke, O;Seegenschmiedt, MH
目的：在进行一般护理模式研究 (PCS) 后，德国良性疾病放射治疗合作小组 (GCG-BD) 发起了一项多中心队列研究，以分析侵袭性纤维瘤病的放射治疗实践。方法和材料：2002 年，通过邮寄标准化结构化调查问卷，在所有德国放射治疗 (RT) 机构进行了 PCS，以评估侵袭性纤维瘤病的患者应计情况、数量、预处理、治疗适应症、RT 和靶区概念。此外，还评估了个别患者的治疗结果。 PCS根据Donabedian的质量评估模型进行构建和分析，分为三个主要部分：结构、过程和结果评估。结果：总共101家机构返回了调查问卷：52.7%报告了满意的临床数据和经验纳入本次分析。每年报告的总发病率为 278 例患者，每个机构中位数为 2 例（1-7 例）。对来自 19 个不同机构的 345 名患者进行了长期临床评估，报告了令人满意的数据。所施加的总剂量范围在 36 至 65 Gy 之间（中位数为 60 Gy）。对于无法切除的肿瘤，初次放疗的局部控制率为 81.4%，术后放疗的局部控制率为 79.6%。未观察到 > 2 级 (RTOG) 的急性或晚期辐射毒性。无法建立明确的剂量-反应关系，但在放疗前接受手术次数较多的患者和接受复发性侵袭性纤维瘤病治疗的患者中，局部控制率有较低的趋势。结论：本研究包含报告的侵袭性纤维瘤病放疗病例的最大数据库。放射治疗在术后环境和不可切除的肿瘤中提供了较高的局部控制率。该 PCS 可以作为国家或国际前瞻性多中心研究或登记或两者的起点。 (C) 2005 爱思唯尔公司。
Purpose: After a general Patterns of Care Study (PCS) the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD) initiated a multicenter cohort study to analyze the radiation therapy practice for aggressive fibromatosis.Methods and Materials: In 2002 a PCS was conducted in all German radiotherapy (RT) institutions by mailing a standardized structured questionnaire, to assess patients accrual, number, pretreatment, treatment indications, RT, and target volume concepts for irradiation in aggressive fibromatosis. In addition, the treatment outcome of individual patients was evaluated. The PCS was structured and analyzed according to the model for quality assessment by Donabedian in three major components: structure, process, and outcome evaluation.Results: A total of 101 institutions returned the questionnaire: 52.7% reported satisfactory clinical data and experience for inclusion in this analysis. A total accrual rate of 278 patients per year was reported with median number of 2 cases (1-7 cases) per institution. Satisfactory data for a long-term clinical evaluation was reported for 345 patients from 19 different institutions. The applied total doses ranged between 36 and 65 Gy (median, 60 Gy). The local control rate was 81.4% in primary RT for unresectable tumors and 79.6% in postoperative RT. No acute or late radiation toxicities > Grade 2 (RTOG) were observed. No clear dose-response relationship could be established, but there was a tendency toward a lower local control rate in patients with a higher number of operative procedures before RT and patients treated for recurrent aggressive fibromatosis.Conclusions: This study comprises the largest database of cases reported for RT in aggressive fibromatosis. Radiotherapy provides a high local control rate in the postoperative setting and in unresectable tumors. This PCS may serve as a starting point for a national or international prospective multicenter study or registry, or both. (C) 2005 Elsevier Inc.