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High‐dose chemotherapy in children with metastatic hepatoblastoma
Author(s) -
Nishimura ShinIchiro,
Sato Takashi,
Fujita Naoto,
Yamaoka Hiroaki,
Hiyama Eiso,
Yokoyama Takashi,
Ueda Kazuhiro
Publication year - 2002
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1046/j.1442-200x.2002.01549.x
Subject(s) - medicine , hepatoblastoma , chemotherapy , thoracotomy , regimen , radiology , bone marrow suppression , surgery , oncology
Background: Despite the advent of effective chemotherapy, a poor prognosis has been reported for patients with metastatichepatoblastoma. To improve this prognosis, we conducted high‐dose chemotherapy with autologous bone marrow rescue in patients withmetastatic hepatoblastoma.Methods and results: Three patients were treated with high‐dose chemotherapy. In patient 1, high‐dose chemotherapywas given after the patient’s first pulmonary relapse. Additional pulmonary metastases, which developed more than 6 monthsafter high‐dose chemotherapy, were treated by multiple thoracotomy without additional chemotherapy. Patient 2 presented additionalpulmonary metastases soon after the end of the first thoracotomy and high‐dose chemotherapy. Because of a decreased serum alpha‐fetoproteinlevel after re‐excision of the pulmonary metastases, a second round of high‐dose chemotherapy was performed. In patient 3, multiplepulmonary metasteses responded to preoperative chemotherapy and disappeared according to the chest computed tomography. Intensivetreatment with a high‐dose chemotherapeutic regimen was performed at the end of postoperative chemotherapy. All three patients are aliveand 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‐dosechemotherapy, may improve the outcome of the patients with metastatic hepatoblastoma.