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
|