Radiotherapy for Dermatofibrosarcoma Protuberans

OBJECTIVES: Dermatofibrosarcoma protuberans (DFSP) is a rare indolent cutaneous tumor. In this analysis, we assess the effectiveness of postoperative radiotherapy (RT) in treating patients with DFSP. METHODS: From 1983 to 2011, 14 patients with DFSP were treated with RT at our institution. One patient had gross disease at the time of RT as he did not have a prior resection. The remaining 13 patients were treated with surgery and postoperative RT. Two patients had DFSP with a fibrosarcomatous component (DFSP-FS). External-beam RT was administered in a continuous course to doses ranging from 55.8 to 66.0 Gy. RESULTS: Follow-up ranged from 1.0 to 23.5 years (median, 10.5). Twelve patients (86%) with DFSP remained disease-free after RT; of those, 11 received postoperative RT and 1 received RT alone. One patient with DFSP-FS died with a local recurrence after surgery, external-beam RT, and a brachytherapy boost. Another patient with DFSP-FS died with diffuse metastatic disease to the lung and chest wall after surgery and RT. There were no serious complications from RT. CONCLUSIONS: RT may improve local control and reduce the risk of recurrence postoperatively in patients with DFSP.