Carcamo Benjamin, Francia Giulio
Department of Pediatric Hematology Oncology, El Paso Children's Hospital, El Paso, TX 79905, USA.
Department of Pediatrics, Texas Tech University Health Science Center, El Paso, TX 79430, USA.
J Clin Med. 2022 May 18;11(10):2849. doi: 10.3390/jcm11102849.
We report a retrospective case series of six Hispanic children with tumors treated with metronomic chemotherapy. The six cases comprised one rhabdoid tumor of the kidney, one ependymoma, two medulloblastomas, one neuroblastoma, and a type II neurocytoma of the spine. Treatment included oral cyclophosphamide daily for 21 days alternating with oral etoposide daily for 21 days in a backbone of daily valproic acid and celecoxib. In one case, celecoxib was substituted with sulindac. Of the six patients, three showed complete responses, and all patients showed some response to metronomic therapy with only minor hematologic toxicity. One patient had hemorrhagic gastritis likely associated with NSAIDs while off prophylactic antacids. These data add to a growing body of evidence suggesting that continuous doses of valproic acid and celecoxib coupled with alternating metronomic chemotherapy of agents such as etoposide and cyclophosphamide can produce responses in pediatric tumors relapsing to conventional dose chemotherapy.
我们报告了一组回顾性病例系列，其中6名西班牙裔儿童接受了节拍化疗治疗肿瘤。这6例病例包括1例肾横纹肌样瘤、1例室管膜瘤、2例髓母细胞瘤、1例神经母细胞瘤和1例脊柱II型神经细胞瘤。治疗方案包括在每日服用丙戊酸和塞来昔布的基础上，口服环磷酰胺21天，每日交替口服依托泊苷21天。在1例病例中，用舒林酸替代了塞来昔布。6例患者中，3例显示完全缓解，所有患者对节拍疗法均有一定反应，仅伴有轻微血液学毒性。1例患者在停用预防性抗酸剂时出现可能与非甾体抗炎药相关的出血性胃炎。这些数据进一步证明，持续剂量的丙戊酸和塞来昔布，联合依托泊苷和环磷酰胺等药物的交替节拍化疗，可使对传统剂量化疗复发的儿科肿瘤产生反应。
