Kasper Bernd, Harter Christoph, Meissner Julia, Bellos Frauke, Krasniqi Fatime, Ho Anthony D, Egerer Gerlinde
Department of Internal Medicine V, University of Heidelberg, Hospitalstrasse 3, 69115 Heidelberg, Germany.
Support Care Cancer. 2004 Mar;12(3):205-7. doi: 10.1007/s00520-003-0573-2. Epub 2004 Jan 16.
We report about a case of advanced Ewing sarcoma in a 30-year-old woman. Initial treatment was started according to the Euro-Ewing 99 protocol. During the initial therapy, an ifosfamide-induced encephalopathy occurred as status epilepticus. Because of cerebral toxicity, the following chemotherapies went without ifosfamide. During final radiotherapy multiple lung metastasis were diagnosed. After two cycles of chemotherapy with cyclophosphamide and topotecan (no response), left thoracotomy, and palliative pneumectomy, the patient was transferred to our ward for further treatment. Undergoing two cycles of chemotherapy with ifosfamide 4 g/m(2) intravenously for 3 consecutive days followed by high-dose chemotherapy (HDCT) according to the ICE-regimen (ifosfamide 2 g/m(2), carboplatin 200 mg/m(2), and etoposide 2 x 100 mg/m(2) intravenously for 6 consecutive days), and peripheral blood stem cell transplantation (PBSCT), complete remission was achieved. Under preventive therapy with methylene blue, thiamin, and glucose 5% infusions, no encephalopathy occurred.
我们报告了一例30岁女性的晚期尤因肉瘤病例。初始治疗按照欧洲尤因99方案开始。在初始治疗期间，发生了异环磷酰胺诱发的脑病，表现为癫痫持续状态。由于脑毒性，后续化疗未使用异环磷酰胺。在最终放疗期间，诊断出多处肺转移。在用环磷酰胺和拓扑替康进行两个周期化疗（无反应）、左开胸手术和姑息性肺切除术后，患者被转至我们病房接受进一步治疗。患者接受了连续3天静脉注射4 g/m²异环磷酰胺的两个周期化疗，随后按照ICE方案（连续6天静脉注射2 g/m²异环磷酰胺、200 mg/m²卡铂和2×100 mg/m²依托泊苷）进行大剂量化疗（HDCT），并进行了外周血干细胞移植（PBSCT），实现了完全缓解。在使用亚甲蓝、硫胺素和5%葡萄糖输注进行预防性治疗期间，未发生脑病。
