Cytotoxic Chemotherapy

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Systemic chemotherapy has been administered to patients with DTs continually growing despite treatment with NSAIDs or anti-oestrogens or rapidly increasing in size thus leading to life-threatening complications. However, chemotherapy is rarely employed because of its toxicity. The published reports regard single cases or small numbers of patients. All treated patients were affected with large tumours, had severe symptoms or major complications. The DTs continued to grow even if medically treated and were deemed unresectable. Various types of cytotoxic drugs were adopted [104-112]. The association with doxorubicin and dacarbazine have generally been chosen in recent years (Table 6). More than 50% of the treated patients achieved significant regression of the lesions and some patients were completely cured. The response to the therapy would appear to last a long time. It has been

Table 6. Results of chemotherapy for mesenteric desmoid

Authors

Type of chemotherapy

Desmoid numbers

Partial response >50%

Complete response

Tsukada et al. 1991 [102] [104]

Vincristine, cyclophosphamide, doxorubicin, 5-FU

8

3

2

Patel et al. 1992 [103] [105]

Doxorubicin, dacarbazine

4

2

2

Lynch et al. 1994 [106]

Doxorubicin, dacarbazine

2

-

1

Schnitzler et al. 1997 [107]

Doxorubicin, dacarbazine

5

3

-

Risum and Bulow [108] 2003

Doxorubicin

1

1

-

Okuno and Edmonson [109] 2003

Ifosfamide, etoposide, mitomycin, doxorubicin, Cis.

4

3

0

Kono et al. [110] 2004

Vinblastine, methotrexate

1

1

-

noted that this favourable response to chemotherapy of DTs defies the dogma in oncology that low-grade tumours without metastatic potential do not respond to chemotherapy [113].

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