多柔比星脂质体联合达卡巴嗪治疗不可手术切除硬纤维瘤的疗效初探

Efficacy of liposomal doxorubicin plus dacarbazine for unresectable desmoid tumor

目的:硬纤维瘤是一种交界性肿瘤,易复发,不转移。对于不可手术切除的硬纤维瘤患者可以考虑药物治疗。本研究探讨使用多柔比星脂质体联合达卡巴嗪方案治疗不可手术切除硬纤维瘤患者的临床效果。方法:选取2015年1月至2019年12月北京大学肿瘤医院收治的35例不可手术切除的硬纤维瘤患者作为研究对象,其中男性11例,女性24例;发病年龄3~53岁,平均年龄27.5岁;肿瘤大小:T2(5~10 cm)6例,T3(10~15 cm)11例,T4(>15 cm)12例,6例多发,无T1(<5 cm)。所有患者均接受多柔比星脂质体联合达卡巴嗪方案化疗,每2个周期进行影像学评效,若有效,至少化疗6个周期,最长12个周期。结果:化疗结束时评效,部分缓解(partial response,PR)10例,疾病稳定(stable disease,SD)24例,疾病进展(progressive disease,PD)1例,无完全缓解(complete response,CR)病例;客观反应率(objective response rate,ORR)为28.6%,疾病控制率(disease control rate,DCR)为97.1%。无进展生存时间(progression-free survival,PFS)2~50个月,中位无进展生存期(median progression-free survival,mPFS)为13个月,平均PFS为14.4个月,23例完成计划化疗患者PFS超过12个月,在5例患者中观察到结束化疗后肿瘤仍持续缩小。结论:对于不可手术切除的硬纤维瘤患者,多柔比星脂质体联合达卡巴嗪方案化疗是一种安全有效的药物治疗方法。

Objective:Desmoid tumor is a borderline tumor that easily recrudesces but never metastasizes.Systemic therapy is recommended for unresectable desmoid tumor.The aim of this study was to assess the efficacy of liposomal doxorubicin plus dacarbazine for unresectable desmoid tumor.Method:Thirty-five patients with unresectable desmoid tumor were treated at Peking University Cancer Hospital&Institute from January 2015 to December 2019.Eleven of them were male and 24 were female.The onset age was 3−53 yrs,and the average age was 27.5 yrs.Tumor sizes were as follows:six T2(5−10 cm),eleven T3(10−15 cm),and twelve T4(>15 cm);six had multiple foci,no T1(<5 cm).All patients received chemotherapy with liposomal doxorubicin plus dacarbazine.Imaging evaluation was conducted every 2 cycles.The treatment plan was from 6 to 12 cycles.Results:At first follow-up,10 cases with partial response(PR),24 cases with stable disease(SD),and 1 case with progressive disease(PD)were observed.The objective response rate(ORR)was 28.6%,disease control rate(DCR)was 97.1%,and progression-free survival(PFS)was from 2−50 months:the median and average PFS were 13 and 14.4 months,respectively.The PFS of 23 patients who completed the planned chemotherapy was over 12 months.In five cases,ongoing shrinkage of the tumor was observed after treatment completion.Conclusions:Liposomal doxorubicin plus dacarbazine is a safe option for local control of unresectable desmoid tumor.