Oral low-dose chemotherapy: successful treatment of an alveolar rhabdomyosarcoma during pregnancy

Abstract

We report for the first time the impact of neoadjuvant oral low-dose chemotherapy consisting of oral trofosfamide, idarubicin, and etoposide (O-TIE) in the case of alveolar rhabdomyosarcoma (RMS) in the lower jaw of an 18-year-old woman at 27 weeks of gestation, without fetal complications and a highly efficient anti-tumor response. Our study suggests the possible application of O-TIE treatment in a neoadjuvant setting during pregnancy and recommends a schedule that can be considered for the treatment of patients with high-risk sarcomas who cannot be treated with intensive chemotherapy for various reasons.

Copyright © 2011 Wiley Periodicals, Inc.

Figures

Fig. 1

O-TIE treatment of 18-year old pregnant women with facial alveolar RMS. (A) Photograph of swelling of the left lower jaw. (B) Follow-up photograph demonstrating resolution of the facial alveolar RMS after oral low-dose chemotherapy with O-TIE. (C) Cranial MRI scan (STIR sequence, coronar, 0.3 TESLA). Tumor mass in the left inferior mandible that extends into the mandibular bone and the soft tissue of the jaw maximum (tumor size: 4.4 × 4.1 × 3.0cm, volume 28ml). (D) Follow-up cranial MRI scan after O-TIE (STIR sequence, coronar, 1.5 TESLA). Clearly marked regression of the extended alveolar RMS in the lower jaw 13 days after last O-TIE chemotherapy (tumor size: 1.5 × 1.2 × 2.1cm, volume 2ml).