ABSTRACT
BACKGROUND: Prognosis of relapsed and refractory neuroblastoma is uniformly fatal; new therapeutic approaches are needed. PROCEDURE: Relapsed and refractory neuroblastoma patients were treated with continuous infusion chemotherapy combined with MIBG. RESULTS: Over 4 years, 35 heavily pretreated patients were registered, 29 with bone or/and bone marrow metastases. Grade 3 or 4 hematologic toxicity was frequent, without toxic deaths. Sixteen patients responded. The probability of 5-year overall survival was 0.19. CONCLUSIONS: This approach is feasible and toxicity manageable; it rescued some patients and prolonged their survival. It merits assay in newly diagnosed high-risk neuroblastoma patients.
Subject(s)
3-Iodobenzylguanidine/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neuroblastoma/drug therapy , Neuroblastoma/secondary , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Neuroblastoma/mortality , Survival RateABSTRACT
El síndrome de Sweet o dermatosis neutrofílica febril aguda forma parte del grupo de las dermatosis neutrofílicas, enfermedades con diagnóstico anatomopatológico, y consiste en el infiltrado de la dermis o de la epidermis por neutrófilos. Su etiología más frecuente es la idiopática, seguida de la paraneoplásica, y parece estar mediada por mecanismos inmunológicos. Su manifestación clínica principal es la aparición de lesiones eritematovioláceas dolorosas que pueden cursar con fiebre (AU)
Subject(s)
Female , Infant , Male , Humans , Sweet Syndrome/diagnosis , Sweet Syndrome/complications , Splenomegaly/etiology , Hepatomegaly/etiology , Adrenal Cortex Hormones/therapeutic use , Potassium Iodide/therapeutic use , Diagnosis, DifferentialABSTRACT
Conventional external beam radiation has proved its profit in pediatric tumors; but its complications have limited it in therapeutical approach. Intraoperative radiotherapy delivers a high single dose in residual tumor or high risk areas during surgery. In our center, during last two years, 7 patients have been candidates to surgery with intraoperative radiotherapy (the age range was between 5 months-17 years; mean 8.5 years). Two patients were excluded of our protocol because of their intraoperative stage. Patients tumors types were: neuroblastoma (n = 3; stage III and IV), soft tissue sarcomas (n = 1) and Ewing's sarcoma (n = 1). The radiation doses ranged from 500 cGyto-1200 cGy. Local control tumor was achieved in 4 patients and no-complications were present secondary to surgery or intraoperative radiotherapy. Intraoperative radiotherapy seems to be a feasible treatment which might promote local control in pediatric tumors with protection of normal tissues and could be an excellent complement in special cases.
Subject(s)
Intraoperative Care , Neoplasms/radiotherapy , Neoplasms/surgery , Adolescent , Child , Child, Preschool , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Infant , Intraoperative Care/methods , Male , Particle AcceleratorsABSTRACT
BACKGROUND: To determine carboxyhemoglobin levels and to investigate carbon monoxide poisoning risk in children. PATIENTS AND METHODS: We determine carboxyhemoglobin blood levels by cooximetry in 65 children, between 15 days and 15 years attended in a pediatric emergency section. We analyze carbon monoxide risk factors (type of heating and smokers in the family). RESULTS: Mean carboxyhemoglobin levels in 59 children without acute intoxication was 0.5 +/- 0.87% (range 0-3.8%). There are no significant differences with respect to age and sex. Children with wood or coal heating (0.88 +/- 1.34%) and gas heating (0.58 +/- 0.97%) have carboxyhemoglobin levels higher than children with electric heating (0.28 +/- 0.4%) but differences were no statistically significant. Four patients have carboxyhemoglobin levels > 2%, two with coal or wood hating and two with gas heating. Children with smokers in the family have carboxyhemoglobin levels higher than the rest of children (0.65 +/- 1.05% versus 0.34 +/- 0.45%) without statistical significance. The four children with carboxyhemoglobin levels > 2% live with smokers. Six children suffered carbon monoxide poisoning with carboxyhemoglobin levels between 20.6 and 36.6%. CONCLUSIONS: Mean carboxyhemoglobin levels in children are low. There are carbon monoxide poisoning risk factors (wood, coal or gas heating at home, and smokers in the family) in a high percentage of the children, although they did not show statistical significance.
