Paediatrics, St George's University Hospitals NHS Foundation Trust, London, UK
Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
BMJ Case Rep. 2021 Jan 28;14(1):e234876. doi: 10.1136/bcr-2020-234876.
We present the first young paediatric patient with desmoplastic small round cell tumour (DSRCT) treated in UK with hyperthermic intraperitoneal chemotherapy (HIPEC). A 7-year-old girl was diagnosed with abdominal DSRCT with peritoneal and liver metastases. After six cycles of chemotherapy she obtained a partial response, including almost complete resolution of the two liver metastases. It was decided to pursue cytoreductive surgery (CRS) combined with HIPEC, a procedure commonly performed in adults, but seldom in a child. The surgery was macroscopically complete and the HIPEC uncomplicated. She continued treatment without delays, including whole abdomino-pelvic radiotherapy and maintenance chemotherapy (cyclophosphamide/vinorelbine for 12 months). She is currently in complete remission 4 months after end of treatment and 26 months after diagnosis. HIPEC was made possible by successful collaboration between multiple teams. CRS-HIPEC proved to be safe and feasible and could be offered to other children with diagnoses of peritoneal malignancies across the UK.
我们报告了首例在英国接受腹腔内热灌注化疗(HIPEC)治疗的小儿弥漫性固有型小圆细胞肿瘤(DSRCT)患者。一名 7 岁女孩被诊断为腹部 DSRCT 合并腹膜和肝脏转移。经过六周期化疗后,她获得了部分缓解,包括两个肝脏转移灶几乎完全消退。决定进行细胞减灭性手术(CRS)联合 HIPEC,这是一种在成人中常施行但在儿童中很少见的手术。手术在宏观上达到完全切除,HIPEC 过程也没有并发症。她继续无延误地接受治疗,包括全腹盆腔放疗和维持化疗(环磷酰胺/长春瑞滨 12 个月)。治疗结束后 4 个月和诊断后 26 个月,她目前处于完全缓解状态。HIPEC 的实施得益于多团队的成功协作。CRS-HIPEC 被证明是安全可行的,可以为英国其他患有腹膜恶性肿瘤的儿童提供。