Efficacy of vinorelbine combined with low-dose methotrexate for treatment of inoperable desmoid tumor and prognostic factor analysis

摘要

Objective:To assess the efficacy of conservative chemotherapy for inoperable desmoid tumor (DT) and analyze the prognostic factors.Methods:From November 2008 to April 2016,71 patients of inoperable DT were treated with vinorelbine and low-dose methotrexate in the Department of Bone and Soft Tissue Tumors,Peking University Cancer Hospital & Institute,and enrolled in this retrospective study.The chemotherapy duration is one year.The efficacy of chemotherapy and the prognosis were observed.Results:Of the 71 patients,55％ were female.Age of onset varied from 1 to 47 years,and the median age was 14 years.Only 11 (15.5％) cases suffered primary tumor.The distribution of the site of tumors was:31 (43.7％) in the trunk,36 (50.7％) in the limbs,and 4 (5.6％) in the peritoneal and pelvic cavity.The size of tumor (the maximum diameter) differed from 2 to 37 cm with a mean of 9.3 cm.The median follow-up duration was 28 (range,6-87) months.Common side effects included:nausea and vomiting,liver injury,bone marrow suppression and oral ulcers.When the chemotherapy finished,1 (1.4％) case achieved complete response,24 (33.8％) achieved partial response,37 (52.1％) achieved stable disease and 9 (12.7％) had progressive disease.The overall response rate was 87.3％.The progression-ftee survival (PFS) of the participants were from 6 to 87 months,and the 2-,3-and 5-year PFS was 79.9％,68.4％ and 36.3％,respectively.No significant difference was identified in PFS in subgroups of gender,age of onset,age of chemotherapy,tumor site and tumor size.Conclusions:For recurrent,inoperable and progressive DT,enough course of chemotherapy with vinorelbine combined with low-dose methotrexate was an optional choice for local control.