Antineoplastics

Abstract

Lack of efficacy and cardiotoxicity: 3 case reports In a study conducted from 1989 to 2014 involving 14 patients, three girls aged 14–16 years were described, of whom two girls, exhibited lack of efficacy with carboplatin, ifosfamide, etoposide, melphalan or cyclophosphamide while being treated for sternal mass NUT carcinoma (NC) or paraspinal L4 NC, and one girl developed cardiotoxicity during treatment with fluorouracil for bronchus NC [routes, durations of treatments to reactions onset and outcomes not stated; not all dosages stated]. The 16-year-old girl (Patient 3 from the article) presented to the hospital with shortness of breath. She was diagnosed with sternal mass NC in 1996. Subsequently, she received treatment on CCG (Children’s Cancer Group) study 0894 consisting of carboplatin [carboplatinum] 400 mg/m2/day, etoposide 100 mg/m2/day and ifosfamide 1800 mg /m2/day for six cycles at 3–4 week intervals. Thereafter, a local mediastinal relapse happened 12 months following diagnosis and she was treated with an autologous rescue using melphalan; however, she progressed and expired 15 months following diagnosis. The 16-year-old girl (Patient 6 from the article) presented with a 2-week history of fever, cough and right-sided chest pain. Subsequently, a diagnosis of lung carcinoma involving bronchus, possibly NC was confirmed. Thereafter, she received fluorouracil [5-fluorouracil] part of the initial cycle of combination therapy that was poorly tolerated and she and developed fluorouracil-induced cardiotoxicity. Thereafter, her therapy was switched to ifosfamide and doxorubicin given with dexrazoxane as cardioprotectant indicating clinical and radiological response with this chemotherapy combination. Therapeutic radiotherapy was started 7months following diagnosis; however, she died of rapidly progressive disease after a month. The 14-year-old girl (Patient 11 from the article) presented to the hospital with right-sided anterior thigh and lower leg pain associated with difficulty of walking and paraesthesia. Subsequently, she was diagnosed with paraspinal L4 NC. She was treated with vincristine, actinomycin, CCG protocol 6902 consisting of carboplatin [carboplatinum], etoposide, and ifosfamide. Three months after the start of chemotherapy revealed little change in the size of the residual mass and radiotherapy was started. Thereafter, autologous peripheral hematopoietic stem cell rescue was carried out following conditioning therapy involving cyclophosphamide 2.2 g/m2, etoposide 100 mg/m2/day and peripheral hematopoietic stem cell rescue with melphalan 200 mg/m2. However, twenty four months following the initial diagnosis, she developed pulmonary metastasis and expired several months later.