Arterial Chemoembolization for the Treatment of Desmoid Fibromatosis
Chemioembolizzazione Arteriosa Per il Trattamento Della Fibromatosi Desmoide: Studio Osservazionale Prospettico
Istituto Ortopedico Rizzoli
20 participants
Feb 20, 2024
OBSERVATIONAL
Conditions
Summary
Desmoid fibromatoses are rare (1-2 cases/million per year) and locally aggressive mesenchymal tumors. For asymptomatic disease, current guidelines suggest an initial period of active surveillance. The current scientific evidence regarding the efficacy and safety of the treatment of desmoid fibromatosis by arterial embolization is constituted by several retrospective and prospective studies. Embolization of desmoid tumors alone, without chemotherapy, on the contrary, has been shown to be inefficient. Using Doxorubicin in desmoid fibromatosis is effective but associated with systemic toxicity. Consequently, this drug is reserved for symptomatic, nonresponsive, rapidly growing or life-threatening tumors. The intrinsic hypervascularity of desmoid tissue can be exploited as a conduit to achieve local distribution of Doxorubicin by navigation of a catheter endovascular.
Eligibility
Inclusion Criteria2
- FIbromatosis demsoid symptomatic and in active phase (documented growth at last follow-ups)
- Patients who are not candidates for surgery or cryoablation
Exclusion Criteria4
- Patients with life expectancy <3 months or severely impaired status functional status (ASA 4)
- Patients with fibromatosis not in active phase, documented clinically and by investigations imaging (MRI, CT)
- Patients with coagulation deficiency or plateletopenic disease
- Patients with documented active infection
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Interventions
* Identification of the main vessels afferent to the metastasis to be treated. * Selective and super-selective catheterization of pathological arterial branches, responsible for the blood supply to the neoplasm, through the use of micro-catheters. * Injection of embolizing material (hydrogel microspheres with doxorubicin) * Control of technical success: the embolization will be followed by diagnostic arteriography that will evaluate the success of the procedure (occlusion of more than 90 percent of the pathologic vasculature).
Locations(1)
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NCT06268457