Dataset Information

Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results.

ABSTRACT:

Purpose

Although locally invasive or recurrent fibromatosis is primarily treated with surgery, radiotherapy (RT) produces local control for recurrent/unresectable tumors or those with positive surgical margins. Herein, we describe our updated institutional experience with RT to treat fibromatosis.

Methods

Forty-seven patients with fibromatosis received RT between 1990 and 2015, and were followed for ?12 months. Eight patients received RT for gross tumors, and 39 received postoperative RT after single/multiple prior surgeries. A median dose of 54 Gy was prescribed for definitive RT; 48.6, 50.4, and 54 Gy were prescribed for R0, R1, and R2 resected tumors, respectively. Recurrences were classified as in-field, marginal, or out-field. Prognostic factors were also evaluated.

Results

Seven recurrences were noted, including 2 in-field, 4 marginal, and 1 out-field, after a median follow-up of 60 months. In-field recurrences occurred in 1 patient who received 40.5 Gy of salvage RT after postoperative recurrence and another who received 45 Gy for R1 resection after multiple prior operations. All marginal failures were due to insufficient clinical target volume (CTV) margins regardless of dose (3 with 45 Gy and 1 with 54 Gy). On multivariate analysis, a CTV margin ?5 cm and dose >45 Gy were significant predictors of non-recurrence (p = 0.039 and 0.049, respectively). Subgroup analysis showed that patients with both an CTV margin ?5 cm and a dose >45 Gy showed a favorable outcome.

Conclusions

RT is a valuable option for treating aggressive fibromatosis; doses ?45 Gy and a large field produce optimal results. For in-field control, a higher dose is more necessary for gross residual tumors than for totally excised lesions.

SUBMITTER: Choi SH

PROVIDER: S-EPMC5973595 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results.

Choi Seo Hee SH Yoon Hong In HI Kim Seung Hyun SH Kim Sang Kyum SK Shin Kyoo-Ho KH Suh Chang-Ok CO

PloS one 20180529 5

<h4>Purpose</h4>Although locally invasive or recurrent fibromatosis is primarily treated with surgery, radiotherapy (RT) produces local control for recurrent/unresectable tumors or those with positive surgical margins. Herein, we describe our updated institutional experience with RT to treat fibromatosis.<h4>Methods</h4>Forty-seven patients with fibromatosis received RT between 1990 and 2015, and were followed for ≥12 months. Eight patients received RT for gross tumors, and 39 received postopera ...[more]

PMID: 29813130

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Project description:Key message Optimal cross selection increases long-term genetic gain of two-part programs with rapid recurrent genomic selection. It achieves this by optimising efficiency of converting genetic diversity into genetic gain through reducing the loss of genetic diversity and reducing the drop of genomic prediction accuracy with rapid cycling. This study evaluates optimal cross selection to balance selection and maintenance of genetic diversity in two-part plant breeding programs with rapid recurrent genomic selection. The two-part program reorganises a conventional breeding program into a population improvement component with recurrent genomic selection to increase the mean value of germplasm and a product development component with standard methods to develop new lines. Rapid recurrent genomic selection has a large potential, but is challenging due to genotyping costs or genetic drift. Here we simulate a wheat breeding program for 20 years and compare optimal cross selection against truncation selection in the population improvement component with one to six cycles per year. With truncation selection we crossed a small or a large number of parents. With optimal cross selection we jointly optimised selection, maintenance of genetic diversity, and cross allocation with AlphaMate program. The results show that the two-part program with optimal cross selection delivered the largest genetic gain that increased with the increasing number of cycles. With four cycles per year optimal cross selection had 78% (15%) higher long-term genetic gain than truncation selection with a small (large) number of parents. Higher genetic gain was achieved through higher efficiency of converting genetic diversity into genetic gain; optimal cross selection quadrupled (doubled) efficiency of truncation selection with a small (large) number of parents. Optimal cross selection also reduced the drop of genomic selection accuracy due to the drift between training and prediction populations. In conclusion optimal cross selection enables optimal management and exploitation of population improvement germplasm in two-part programs.

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Dataset Information

Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results.

Purpose

Methods

Results

Conclusions

Publications

Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results.

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