Pre-operative High-dose chemotherapy for infantile hepatoblastoma (PRETEXT IV)-review of our two cases

  • MUTO,Mitsuru
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital
  • HIROBE,Seiichi
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital
  • TOMA,Miki
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital
  • KOMORI,Koji
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital
  • OKUMURA,Kenji
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital
  • KANEKO,Takashi
    Department of Hematology and Oncology, Tokyo Metropolitan Kiyose Children's Hospital
  • YONEYAMA,Hiroshi
    Department of Hematology and Oncology, Tokyo Metropolitan Kiyose Children's Hospital
  • SUGITA,Mayumi
    Department of Hematology and Oncology, Tokyo Metropolitan Kiyose Children's Hospital
  • HUKUOKA,Kohei
    Department of Hematology and Oncology, Tokyo Metropolitan Kiyose Children's Hospital
  • MORIKAWA,Masahiko
    Department of Pathology, Tokyo Metropolitan Kiyose Children's Hospital
  • KAMAGATA,Syoichiro
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital
  • HAYASHI,Akira
    Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital

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Other Title
  • 術前超大量化学療法を行ったPRETEXT IV乳児肝芽腫2症例の検討

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Description

We report on two cases of infantile hepatoblastoma specified as PRETEXT (Pre-Treatment Extent of Disease) IV. Regimen CITA and ITEC prescribed by the JPLT-2 (Japanese Study Group for Pediatric Liver Tumor) protocol were invalid in both cases. Then, the extensive high-dose chemotherapy followed by an autologous bone marrow transplant were tried. Consequently, regimen Hi-MEC (Melpharan+Etoposide+Carboplatin) showed a poor response. On the other hand, regimen Hi-MT (Melpharan+thio-TEPA) had a great effect and the tumor could be excised completely. This is the first report about "preoperative high-dose chemotherapy" based on the JPLT-2 protocol. Hi-MT was thought to be a suitable treatment when standard chemotherapy was not effective. The treatment strategy for unresectable infantile hepatoblastoma was considered based on our experience.

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