mesna and Thoracic-Neoplasms

Important advances have been obtained in the care of soft tissue sarcoma in adults, mainly in the field of locoregional treatment. Surgery or combination of surgery and radiotherapy allow adequate tumor control with preservation of function for the majority of patients. However, the management of locally advanced primaries remains problematic. Moreover, although patients survival mainly depends on the metastatic risk of the disease, controversies remain in definition of pronostic factors as well as in the evaluation of the role of chemotherapy in curative therapeutical strategies. The case reported here allows a discussion of the different modalities of treatment for adults with soft tissue sarcomas and stresses the necessity of a multimodal approach in these patients.

Topics: Antineoplastic Combined Chemotherapy Protocols; Back; Chemotherapy, Adjuvant; Combined Modality Therapy; Dacarbazine; Doxorubicin; Humans; Ifosfamide; Magnetic Resonance Imaging; Male; Mesna; Middle Aged; Neoplasm Invasiveness; Prognosis; Radiotherapy Dosage; Sarcoma; Soft Tissue Neoplasms; Thoracic Neoplasms

Topotecan is an active drug in relapsed neuroblastoma. We investigated the efficacy and toxicity of a topotecan-based induction regimen in newly diagnosed neuroblastoma.. Patients older than 1 year with either metastatic or localised stage 2-3 MYCN-amplified neuroblastoma received 2 courses of high-dose topotecan (HD-TPT) 6mg/m(2) and high-dose cyclophosphamide (HD-CPM) 140 mg/kg, followed by 2 courses of ifosfamide, carboplatin and etoposide (ICE) every 28 days. After surgery on primary tumour, a fifth course with vincristine, doxorubicin and CPM was given, followed by high-dose chemotherapy with stem cell support. Response was assessed in accordance with the International Neuroblastoma Response Criteria.. Of 35 consecutive patients, 33 had metastatic disease. The median length of induction phase was 133 days (range 91-207) and time to high-dose chemotherapy was 208 days (range 156-285). The median tumour volume reduction was 55% after two HD-TPT/HD-CPM courses and 80% after four courses. Radical surgery was performed in 16/27 patients after chemotherapy. After the fifth course, 29/34 patients (85%) had achieved a partial remission (12) or a CR/very good partial remission (17). CR of metastases was achieved in 13/32 (41%) and bone marrow was in complete remission in 16/24 patients (67%). Grade 4 neutropenia and/or thrombocytopenia occurred in 100% of HD-TPT/HD-CPM and in 95% of ICE courses, while non-haematological toxicities were manageable.. These data indicate that our induction regimen is feasible and well tolerated. A major response rate of 85% with 41% complete metastatic response confirms this regimen as effective induction in high-risk neuroblastoma.

Topics: Abdominal Neoplasms; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Child; Child, Preschool; Etoposide; Female; Humans; Ifosfamide; Infant; Kaplan-Meier Estimate; Lomustine; Male; Melphalan; Mesna; Neuroblastoma; Pilot Projects; Risk Factors; Thoracic Neoplasms; Topotecan; Treatment Outcome

Retroperitoneal synovial sarcomas are very rare. The authors describe a 39-year-old male with a primary retroperitoneal synovial sarcoma showing a monophasic pattern. Immunohistochemically, the tumor cells were positive for cytokeratin AE1/AE3, epithelial membrane antigen, vimentin, S-100 protein, CD99 and calretinin. The differential diagnosis, clinical evolution and principles of treatment are shortly discussed.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Dacarbazine; Doxorubicin; Humans; Ifosfamide; Male; Mast Cells; Mesna; Mitosis; Retroperitoneal Neoplasms; Sarcoma, Synovial; Thoracic Neoplasms

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Drug Administration Schedule; Etoposide; Female; Forearm; Hemangiopericytoma; Humans; Ifosfamide; Lung Neoplasms; Male; Mesna; Neoplasm Recurrence, Local; Salvage Therapy; Thoracic Neoplasms