High-dose chemotherapy in children with metastatic hepatoblastoma.

Abstract

BACKGROUND:

Despite the advent of effective chemotherapy,a poor prognosis has been reported for patients with metastatic hepatoblastoma. To improve this prognosis, we conducted high-dose chemotherapy with autologous bone marrow rescue in patients with metastatic hepatoblastoma.

METHODS AND RESULTS:

Three patients were treated with high-dose chemotherapy. In patient 1, high-dose chemotherapy was given after the patient's first pulmonary relapse. Additional pulmonary metastases, which developed more than 6 months after high-dose chemotherapy, were treated by multiple thoracotomy without additional chemotherapy. Patient 2 presented additional pulmonary metastases soon after the end of the first thoracotomy and high-dose chemotherapy. Because of a decreased serum alpha-fetoprotein level after re-excision of the pulmonary metastases, a second round of high-dose chemotherapy was performed. In patient 3, multiple pulmonary metasteses responded to preoperative chemotherapy and disappeared according to the chest computed tomography. Intensive treatment with a high-dose chemotherapeutic regimen was performed at the end of postoperative chemotherapy. All three patients are alive and well, more than 6 years after receiving their diagnosis.

CONCLUSION:

The role of high-dose chemotherapy in treatment of metastatic hepatoblastoma could not be clarified,because of the small number of patients. However, the better outcome of our patients indicates that multimodal therapy, including high-dose chemotherapy, may improve the outcome of the patients with metastatic hepatoblastoma.

• Authors: Shin-Ichiro Nishimura, Takashi Sato, Naoto Fujita, Hiroaki Yamaoka, Eiso Hiyama, Takashi Yokoyama, Kazuhiro Ueda
• Journal: Pediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 44 Issue 3 Pg. 300-5 (Jun 2002) ISSN: 1328-8067 [Print] Australia
• PMID: 11982901 (Publication Type: Case Reports, Journal Article)

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Marrow Transplantation
• Child
• Child, Preschool
• Hepatoblastoma (drug therapy, secondary, surgery)
• Humans
• Infant
• Liver Neoplasms (pathology)
• Lung Neoplasms (drug therapy, secondary, surgery)
• Male
• Pneumonectomy
• Prognosis