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To assess the relapse-free survival (RFS) and the factors influencing local recurrence in patients with desmoid fibromatosis (DF) treated at our centre and to determine the role of post-operative radiotherapy (RT) in improving local control.
A retrospective analysis of 51 patients treated for DF from January 2004 to December 2013 was undertaken. The RFS was calculated using the Kaplan–Meier curve. Univariate analysis was done to assess correlation with tumour size, site, the extent of surgery, margin status and adjuvant RT with RFS.
The median age was 28 years with a male:female ratio of 1:3. The most common location of the tumour was anterior abdominal wall (47%). The median tumour size was 10 cm. Wide local excision was done in most patients. Complete resection with negative margin was achieved in eight patients. Post-operative RT was indicated for 43 patients of whom 19 received RT. At a median follow-up of 37 months, RFS in the complete resection with margin negative group was 100%. RFS for the patients with positive or close margins who received RT was 79% and for those who did not receive RT, it was 87%.
Complete excision with negative margins gives the best local control in DF. The benefit of post-operative RT could not be ascertained.
To compare the dosimetric outcomes of linear accelerator-based stereotactic radiotherapy (SRT) techniques—static conformal field (SCF), static conformal arc (SCA) and dynamic conformal arc (DCA), for treating pituitary adenoma and craniopharyngioma.
Materials and methods
Computer image sets of 20 patients with pituitary adenoma or craniopharyngioma and treated with post-operative SRT were selected for this study. For each dataset, three SRT plans, with SCF, SCA and DCA techniques were generated using Brain LAB, iPlan RT V.4.5.3, TPS software. The conformity index (CI), homogeneity index (HI), quality of coverage of the target, dose–volume histograms for the target and organs at risk (OARs) and the time taken to deliver treatment was compared across three sets of plan.
There were 12 patients with pituitary adenoma and eight with craniopharyngioma. The CI and HI were comparable across three techniques. The quality of coverage was superior in DCA technique. OARs were better spared in SCF and DCA techniques. Time taken to deliver treatment was least in SCF technique.
The linac-based SRT techniques SCF, SCA and DCA are efficient in delivering highly conformal and homogenous dose to the target in pituitary adenoma and craniopharyngioma. Among these three techniques, SCF and DCA had acceptable quality of coverage. The dose received by OARs was least in the SCF technique.
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