cactinomycin and Thoracic-Neoplasms

We report two cases of extraosseous Ewing's sarcoma revealed by large volume thoracic tumour lesions, occurring in a clinical context of an alteration in general health. The tumour mass was occupying the upper half of the left hemithorax, and was invading the thoracic wall posteriorly in the first case; it occupied the whole of the right hemithorax with invasion of the first three ribs in the second case. The first patient received five treatments with chemotherapy, using cyclophosphamide in association with adriamycin, which led to a partial response and was completed with surgical excision and a further five doses of chemotherapy using cyclophosphamide in association with etoposide. Subsequently radiotherapy was given. There was an unfavorable outcome, with recurrence in the 13th month. The second patient received three courses of chemotherapy using cyclophosphamide in association with actinomycin D and vincristine, which allowed for an 80% reduction in the tumour volume. Surgical resection was then carried out, followed by five courses with the same chemotherapy protocol. Forty-two months after the diagnosis this patient remained in complete remission. These two cases enable us to stress the value of associating a chemotherapy protocol consisting of cyclophosphamide, actinomycin D and vincristine, with systemic surgical excision in tumours with a high potential for development.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Cyclophosphamide; Dactinomycin; Doxorubicin; Etoposide; Female; Humans; Male; Sarcoma, Ewing; Thoracic Neoplasms; Tomography, X-Ray Computed; Vincristine