Highlights
- •Literature regarding TKI and radiotherapy for unresectable DFSP are reviewed in detail.
- •TKI may be employed against all DFSP histology types, with 70–95% clinical benefit.
- •Radiotherapy alone may be limited to low-grade classic DFSP, with 90% clinical benefit.
- •Patient selection is paramount and adverse effect profiles must be considered.
Abstract
Background
In unresectable dermatofibrosarcoma protuberans (DFSP), no clear guideline exists
regarding the use of tyrosine kinase inhibitors (TKI) versus radiotherapy. This study
reviews current literature regarding TKI and radiotherapy in unresectable DFSP.
Methods
Following PROSPERO registration (CRD42021232508), a systematic literature search was
performed including all studies reporting clinical results of TKI and/or radiotherapy
in the treatment of unresectable DFSP. A narrative synthesis was used to compare patient
characteristics, outcomes, and adverse effects.
Results
Of 1345 screened studies, 14 were included for review. Patient age ranged 18–77 years
and 55% were male. Radiotherapy patients exhibited lower grade disease than TKI patients.
Overall clinical benefit following TKI ranged from 70% to 96%. Radiotherapy patients
exhibited control or resolution on last follow-up in 90% of cases. Radiotherapy adverse
effects were mild, while TKI adverse effects were more severe and managed with dose
reduction.
Conclusion
TKI may be employed in unresectable DFSP of all histology types whereas radiation
alone may be limited to low-grade and classic-type DFSP. TKI may cause more severe
adverse effects compared to radiation alone.
Keywords
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Article info
Publication history
Published online: September 25, 2022
Accepted:
September 20,
2022
Received in revised form:
September 18,
2022
Received:
July 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
