Undifferentiated nasopharyngeal carcinoma in children: a report of four cases.

Nasopharyngeal carcinoma in early stages in children is a highly curable neoplasm. The major cause of treatment failure is the development of distant metastases, predominantly in advanced stages. This paper reports about four young patients with undifferentiated nasopharyngeal carcinoma treated with preradiation chemotherapy, locoregional radiotherapy and maintenance chemotherapy up to a total period of two years. Treating these four children, we noticed that preradiation chemotherapy caused satisfactory regression of the primary tumor. Three patients are still without signs of disease after 28 to 88 months and one died due to tumor progression. Further studies have to confirm our observations and support research in designing the optimal combination of effective chemotherapeutic agents and radiotherapy.

[Current concepts on the treatment of glioma of optic nerve and chiasm]. / Savremeni pristupi u lecenju glioma optickog nerva i hijazme

Based on the data from literature, the authors present current concepts on the treatment of glioma of the optic nerve and chiasm. The influence of location and biological behaviour of these tumours on making decision about the most appropriate treatment regarding the results and minimum of side-effects, is emphasized.

Preoperative intra-arterial chemotherapy in patients with osteosarcoma: case report of seven patients below the age of 18 years.

In the period between 1987 and 1989, seven patients under 18 years of age with osteosarcoma of a lower limb were treated by preoperative intra-arterial chemotherapy. The age of the patients ranged from 12 to 17 years, the median age being 14.5 years. The polyethylene catheter was placed surgically into the lower epigastric artery. Two combinations of cytostatics were administered: adriamycin-bleomycin-cisplatin and high-dose methotrexate-vincristine-cisplatin. All patients, after two or three courses, underwent surgical resection of limb tumor. Tumor destruction ranged from 20 to 100%. Four patients with necrosis from 80-100% remained free of disease from 18 to 30 months: two, having necrosis of 40% and 95% respectively, died. The youngest patient whose necrosis was as low as 20%, after completion of the systemic chemotherapy, developed local recurrence and pulmonary metastases.

Acute toxicity from BOPP (BCNU, vincristine, procarbazine, cisplatinum) chemotherapy for glioblastoma multiforme.

Between January 1988 and October 1988, we treated 12 patients with glioblastoma multiforme with BOPP chemotherapy after surgery and radiotherapy. The protocol consisted of BCNU 50 mg/m2 days 1-3, vincristine 1.4 mg/m2 (maximum 2 mg) day 1, procarbazine 50 mg/m2, days 1-7 and cisplatinum 20 mg/m2, days 1-3. All patients had at least three courses of chemotherapy ECOG toxicity criteria were used. We observed 9/12 changes in WBC, 7/12 in Hgb. All patients had nausea and vomiting. We also observed 2/12 neuropathies related to CNS. Other toxicities were not observed.

[Use of chemotherapy in brain tumors in children--possibilities and perspectives]. / Primena hemioterapije kod tumora mozga u dece--mogucnosti i perspektive.

In the past two decades a huge progress was achieved in the treatment of malignant diseases in children. The cyclical chemotherapy combined with surgery and radiotherapy gave very good results. However, the contribution of chemotherapy to paediatric neuro-oncology was not as great is it was to other branches of paediatric oncology (acute leukaemia, malignant lymphoma, Wilms' tumour). One of the reasons is that although brain tumours are usually solid in children the existence of different histological types contributes to the fact that they are not very frequent or are rare. Consequently, for many types the necessary number of representative controlled studies is lacking. On the other hand, the leading paediatric oncology associations in the world (Children's Cancer Study Group (CCSG), International Society of Paediatric Oncology (SIOP) and Paediatric Oncology Group (POG)) have applied the prospective clinical programmes of treatment of these tumours later than in other malignant diseases. On the basis of the analysis of these programmes and experience of individual oncological centres a certain experience was acquired in present-day possibilities of chemotherapy in children suffering from brain tumours.

[Intracranial malignant melanoma in childhood]. / Intrakrainjumski maligni melanom decjeg doba.

Malignant melanoma is a very uncommon tumour in childhood. Over the period from 1978 to 1987 998 children were treated with radiotherapy for different malignant diseases. Only two children were treated for melanoma. The authors present a 12-year-old boy with malignant melanoma of the central nervous system which appeared in the left parieto-occipital region. All clinical, laboratory, radiological and other examinations could discover no other lesion except the CNS (primary or metastatic). The boy was operated on (partial extirpation) and radiotherapy was performed with 60Gy/30f. The boy completely recovered for a short time. He died 14 months after the onset of symptoms and 12 months after the beginning of the treatment. This clinical course suggests a rapid progression of primary brain melanoma.