Radiothérapie des tumeurs desmoïdes extra abdominales
Mots-clés :
Tumeur desmoïde, fibromatose agressive, radiothérapie, traitement, contrôle localRésumé
Prérequis : Les tumeurs desmoïdes (TD) sont des tumeurs bénignes rares mais à "malignité" locale. Elles peuvent infiltrer les structures adjacentes vasculo-nerveuses et osseuses.
But : Etudier la place de la radiothérapie dans les TD extra abdominales traitées par radiothérapie après exérèses chirurgicales.
Méthodes : Etude rétrospective incluant six tumeurs desmoïdes extra-abdominales traitées par chirurgie et radiothérapie.
Résultats : L'âge médian des patients était de 26,8 ans (16 à 35 ans).
La tumeur siégeait au niveau du membre supérieur (1 cas), des membres inférieurs (2 cas) et du tronc (3 cas). La taille tumorale moyenne était de 86,6 mm (60 à 100 mm). Cinq patients avaient présenté une récidive locale après exérèse chirurgicale. L’énergie utilisée pour la radiothérapie était le cobalt 60 dans cinq cas et une association photons-électrons de l’accélérateur linéaire dans un cas.
La dose totale était de 54 à 62 Gy. L'étalement moyen était de 40 jours avec un maximum de 51 jours. Le contrôle tumoral a été obtenu dans 5 cas après un recul moyen de 26 mois (extrêmes : 1 et 83 mois) après la fin de la radiothérapie.
Conclusion : Le traitement de choix des TD repose sur la chirurgie mais les taux de rechute locale restent élevés même après exérèse complète. L’indication d’une radiothérapie adjuvante est controversée.
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