Low-dose chemotherapy for extra-abdominal desmoid tumor.

Objective: To assess the outcome of patients with extra-abdominal desmoid tumor treated with low dose chemotherapy (methotrexate and vinblastine) both for tumor response and treatment related toxicity.

Methods: We retrospectively reviewed the outcome of 12 patients who underwent low dose chemotherapy for extra abdominal desmoid of different locations. The study took place in the McGill University Health Center, Montreal, Canada between 1996 and 2003. We evaluated the patients for their compliance, tumor response, complications of treatment, and impact of treatment on symptoms. There were 7 females and 5 males with a mean age of 46 years.

Results: Disease related morbidity included pain in 7 patients, functional limitation in 7 and cosmetic defects in 3. The mean tumor size was 11 cm (3-20 cm). The mean follow-up was 43 months (15-71 months). Chemotherapy was administered weekly. Complications were significant. Only 2 patients did not experience the toxicity. According to Response Evaluation Criteria in Solid Tumors, 6 tumors showed a partial response and 6 remained stable. None showed progression. Of the 7 patients who had painful tumors, 6 achieved significant symptom relief. Function was improved in 3 and restored to normal in 4. Cosmesis was improved in 2 of the 3. At latest follow-up, tumors remained stable in 8, one has markedly regressed and 3 exhibited progression at an average of 54 months. Only one patient required surgery. The only long term side effect was a sensory peripheral neuropathy.

Conclusion: Low dose chemotherapy was found to be a valuable adjunct to prevent local progression and improve symptoms.