Small cell osteosarcoma successfully treated by high-dose ifosfamide and methotrexate, combined with carboplatin and pirarubicin.
Small cell osteosarcoma successfully treated by high-dose ifosfamide and methotrexate, combined with carboplatin and pirarubicin.
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发表时间：
2012-03
影响因子：
2
通讯作者：
H. Futani;S. Fukunaga;Y. Tsukamoto;N. Terada;Junichiro Ono;N. Okamoto;Y. Otsuka;T. Tanizawa;M. Tomatsuri;S. Yoshiya
中科院分区：
文献类型：
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作者：
H. Futani;S. Fukunaga;Y. Tsukamoto;N. Terada;Junichiro Ono;N. Okamoto;Y. Otsuka;T. Tanizawa;M. Tomatsuri;S. Yoshiya
小细胞骨肉瘤（SCO）是骨肉瘤中最罕见的亚型，预后差。一个11岁的男孩提出了2个月的历史疼痛肿胀在小腿。影像学分析显示胫骨近端和骨外区存在溶骨性和骨质疏松性病变。开放性活检的组织学显示小圆细胞产生粘液基质。根据这些调查结果，SCO被怀疑。该患者接受了3个周期的新辅助化疗，使用高剂量异环磷酰胺、高剂量甲氨蝶呤、吡拉韦和卡铂。采用Ilizarov方法进行宽缘切除，然后进行胫骨延长，并使用与新辅助化疗相同的药物进行两个周期的辅助化疗。切除标本的组织学显示几乎所有的肿瘤细胞都坏死了。术后4年无复发和转移。我们的经验表明，新辅助化疗，如这里使用的，将是非常有效的SCO没有严重的非血液学毒性。
Small cell osteosarcoma (SCO) is the most rare subtype of osteosarcoma and has a poor prognosis. An 11-year-old boy presented with 2-month history of painful tumefaction in the lower leg. Imaging analysis demonstrated a mixture of osteolytic and osteosclerotic lesions in the proximal tibia and extraskeletal area. Histology of the open biopsy showed small round cells producing mucous matrix. Based on these findings, SCO was suspected. The patient received three cycles of neoadjuvant chemotherapy using high-dose ifosfamide, high-dose methotrexate, pirarubicin and carboplatin. Wide-margin resection was performed followed by tibial lengthening using the Ilizarov method and two cycles of adjuvant chemotherapy with the same drugs as for neoadjuvant chemotherapy. Histology of the resected specimen showed that almost all tumor cells were necrotized. Neither recurrence nor metastasis was found after 4 years. Our experience suggests that neoadjuvant chemotherapy, such as the one used here, would be exceedingly effective for SCO without serious non-hematological toxicities.