The Journal of Bone and Joint Surgery, Vol 73, Issue 5 717-725, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Radiation therapy for aggressive fibromatosis. The Experience at the University of Florida
WM McCollough, JT Parsons, R van der Griend, WF Enneking and T Heare
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville.
Twenty-nine patients (thirty sites) who had histologically confirmed
aggressive fibromatosis were treated with radical courses of radiation at
the University of Florida between March 1975 and February 1986. The minimum
length of follow-up was two years; 76 per cent of the patients were
followed for more than five years. Twenty-seven sites received doses of at
least 5000 centigrays (one centigray equals one rad). Twelve patients were
treated twice a day. Fourteen sites were treated with radiation
postoperatively for known or presumed microscopic quantities of residual
aggressive fibromatosis; in eleven, the disease was locally controlled.
Sixteen sites were treated postoperatively for known grossly apparent
residual disease; in fourteen, the disease was locally controlled.
Over-all, aggressive fibromatosis was controlled in twenty-five (83 per
cent) of the thirty sites. The six-year actuarial rate of local control was
79 per cent. The five local recurrences occurred at four, eleven,
thirty-four, sixty-one, and sixty-eight months after the initiation of
radiation therapy. Two of the five failures occurred in the high-dose
radiation field in patients who were treated for grossly apparent disease.
The remaining three failures occurred at the margin of the irradiated field
in patients who were treated for assumed microscopic quantities of residual
disease. There was no apparent difference in local control between patients
who were treated for primary (previously untreated) aggressive fibromatosis
and those who were treated after one or more recurrences. Comparison of the
results of radiation therapy with published data on operative treatment
shows that local control substantially improves with postoperative
radiation therapy when operative margins are less than wide.(ABSTRACT
TRUNCATED AT 250 WORDS)
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