Use of doxorubicin and dacarbazine for the management of unresectable intra-abdominal desmoid tumors in Gardner's syndrome

Henry T. Lynch, Robert Joseph Fitzgibbons, Sandra Chong, Jennifer Cavalieri, Jane Lynch, Franc Wallace, Shreyaskumar Patel

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Abstract

PURPOSE: The aim of this study was to describe the natural history and management of surgically unresectable intra-abdominal desmoid tumors in two patients with Gardner's syndrome from two unrelated families, where each had failed on conventional therapy. METHODS: Two patients with Gardner's syndrome were placed on a chemotherapy regimen which included doxorubicin (90 mg/m2) and dacarbazine (900 mg/m2) in divided doses over four days of continuous infusion. Their progress on chemotherapy was assessed by abdominal computerized tomography and laparoscopy. RESULTS: The computerized abdominal tomography scans proved difficult to interpret because of adhesions and matted small bowel resulting from the patients original colectomies. These findings made it difficult to differentiate postoperative changes from residual desmoid tumor. Second-look laparotomy in such patients was contraindicated as this may predispose to further desmoid production. Laparoscopy disclosed a complete response to this chemotherapy. Nevertheless, we had an iatrogenic small bowel perforation in one of these patients. Each patient showed a complete response to chemotherapy. CONCLUSION: Surgical resection remains the first-line treatment of intra-abdominal desmoid tumors. However, doxorubicin/ dacarbazine chemotherapy on a clinical trial basis may be indicated in patients whose intra-abdominal desmoid is unresectable, or who have failed to respond to treatment with hormones (tamoxifen, Toremifene), steroids (prednisone), and nonsteroidal anti-inflammatory agents (Clinoril®; Merck & Co., Inc., West Point, PA).

Original languageEnglish
Pages (from-to)260-267
Number of pages8
JournalDiseases of the Colon and Rectum
Volume37
Issue number3
DOIs
StatePublished - Mar 1994

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Gardner Syndrome
Aggressive Fibromatosis
Dacarbazine
Doxorubicin
Drug Therapy
Neoplasms
Laparoscopy
Toremifene
Tomography
Sulindac
Colectomy
Residual Neoplasm
Non-Steroidal Anti-Inflammatory Agents
Tamoxifen
Prednisone
Natural History
Laparotomy
Therapeutics
Steroids
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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Use of doxorubicin and dacarbazine for the management of unresectable intra-abdominal desmoid tumors in Gardner's syndrome. / Lynch, Henry T.; Fitzgibbons, Robert Joseph; Chong, Sandra; Cavalieri, Jennifer; Lynch, Jane; Wallace, Franc; Patel, Shreyaskumar.

In: Diseases of the Colon and Rectum, Vol. 37, No. 3, 03.1994, p. 260-267.

Research output: Contribution to journalArticle

Lynch, Henry T. ; Fitzgibbons, Robert Joseph ; Chong, Sandra ; Cavalieri, Jennifer ; Lynch, Jane ; Wallace, Franc ; Patel, Shreyaskumar. / Use of doxorubicin and dacarbazine for the management of unresectable intra-abdominal desmoid tumors in Gardner's syndrome. In: Diseases of the Colon and Rectum. 1994 ; Vol. 37, No. 3. pp. 260-267.
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