All-trans retinoic acid and interferon-α in the treatment of a patient with resistant metastatic osteosarcoma -: A case report

被引:0
|
作者
Todesco, A
Carli, M
Iacona, I
Frascella, E
Ninfo, V
Rosolen, A
机构
[1] Univ Padua, Azienda Osped, Clin Oncoematol Pediat, I-35128 Padua, Italy
[2] IRCCS Policlin S Matteo, Dipartimento Farmacol, Pavia, Italy
[3] Univ Padua, Ist Anat Patol, I-35100 Padua, Italy
关键词
osteosarcoma; interferon; retinoic acid; metastasis; child;
D O I
10.1002/1097-0142(20001215)89:12<2661::AID-CNCR20>3.0.CO;2-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. A boy age 14 years who was in complete remission from Stage IIB small cell osteosarcoma, which was misdiagnosed as Ewing sarcoma and consequently was treated, developed inoperable lung metastases when he was off therapy. He received second-line treatment for recurrent Ewing sarcoma, including chemotherapy and radiotherapy, and obtained only a temporary response. A compassionate treatment with all-trans retinoic acid (ATRA) and interferon-cu (IFN alpha) was then undertaken. METHODS. The patient initially was treated according to the national SE91 protocol for nonmetastatic Ewing sarcoma. After a bilateral pulmonary recurrence, he received second-line chemotherapy and irradiation of the largest metastasis, with a temporary partial response. The patient was then treated with a combination of oral ATRA (90 mg/m(2) for 3 days per week) and subcutaneous IFN alpha (3 x 10(6) U/m(2) 5 days per week) for 4 months. The same therapy also was administered for the control of residual disease after surgery for a total duration of 1 year of ATRA/IFN treatment. During the first 3 weeks of therapy ATRA pharmacokinetics were studied. RESULTS, After progression of the patient's disease, despite the administration of first-line and second-line chemotherapy, combined treatment with ATRA/IFN alpha( yielded a partial remission, which allowed surgical resection of the largest metastasis. The same therapy was effective in preventing tumor recurrence after incomplete removal of the remaining metastases. Treatment was well tolerated, and the patient is in stable complete remission 14 months after the end of therapy. The pharmacokinetics results confirmed the indication of an intermittent schedule for oral ATRA therapy. CONCLUSIONS. ATRA/IFN alpha treatment may be considered as an alternative approach in the treatment of patients with metastatic osteosarcoma who have disease that is resistant to conventional chemotherapy and in the treatment of patients with minimal tumor residue. Cancer 2000;89:2661-6. (C) 2000 American Cancer Society.
引用
收藏
页码:2661 / 2666
页数:6
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