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Successful treatment of infantile fibrosarcoma spinal metastasis by chemotherapy and stereotactic hypofractionated radiotherapy.

Lo CH, Cheng SN, Lin KT, Jen YM - J Korean Neurosurg Soc (2013)

Bottom Line: We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass.This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months.This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taiwan, ROC.

ABSTRACT
We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife® stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

No MeSH data available.


Related in: MedlinePlus

Sagittal unenhanced T1-weighted (A), sagittal and axial gadolinium-enhanced T1-weighted fat-suppressed (B and C) MRI scans shows the well-delineated boundary of the irradiated 4th lumbar vertebral column with fatty changes in the bone marrow, which is consistent with post-irradiation bone change. Note the shrinkage of the contrast-enhancing lesion with the reduction of tumor volume from 2.2 cm3 to 1.7 cm3, i.e., 23% after radiotherapy.
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Figure 3: Sagittal unenhanced T1-weighted (A), sagittal and axial gadolinium-enhanced T1-weighted fat-suppressed (B and C) MRI scans shows the well-delineated boundary of the irradiated 4th lumbar vertebral column with fatty changes in the bone marrow, which is consistent with post-irradiation bone change. Note the shrinkage of the contrast-enhancing lesion with the reduction of tumor volume from 2.2 cm3 to 1.7 cm3, i.e., 23% after radiotherapy.

Mentions: The patient tolerated the anesthesia and immobilization well and remained still during the radiotherapy. Up to the date of this report, i.e., 33 months after radiotherapy, the patient remains neurologically stable and 23% reduction in tumor volume was achieved on the surveillance MRI scans (Fig. 3). No acute radiation toxicity was found.


Successful treatment of infantile fibrosarcoma spinal metastasis by chemotherapy and stereotactic hypofractionated radiotherapy.

Lo CH, Cheng SN, Lin KT, Jen YM - J Korean Neurosurg Soc (2013)

Sagittal unenhanced T1-weighted (A), sagittal and axial gadolinium-enhanced T1-weighted fat-suppressed (B and C) MRI scans shows the well-delineated boundary of the irradiated 4th lumbar vertebral column with fatty changes in the bone marrow, which is consistent with post-irradiation bone change. Note the shrinkage of the contrast-enhancing lesion with the reduction of tumor volume from 2.2 cm3 to 1.7 cm3, i.e., 23% after radiotherapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921285&req=5

Figure 3: Sagittal unenhanced T1-weighted (A), sagittal and axial gadolinium-enhanced T1-weighted fat-suppressed (B and C) MRI scans shows the well-delineated boundary of the irradiated 4th lumbar vertebral column with fatty changes in the bone marrow, which is consistent with post-irradiation bone change. Note the shrinkage of the contrast-enhancing lesion with the reduction of tumor volume from 2.2 cm3 to 1.7 cm3, i.e., 23% after radiotherapy.
Mentions: The patient tolerated the anesthesia and immobilization well and remained still during the radiotherapy. Up to the date of this report, i.e., 33 months after radiotherapy, the patient remains neurologically stable and 23% reduction in tumor volume was achieved on the surveillance MRI scans (Fig. 3). No acute radiation toxicity was found.

Bottom Line: We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass.This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months.This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taiwan, ROC.

ABSTRACT
We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife® stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

No MeSH data available.


Related in: MedlinePlus