Osteosarcoma following radiation treatment for meningioma: report of a case and effective treatment with chemotherapy.

A case of effective chemotherapy in postirradiation sarcoma is reported. A 30-year-old woman underwent a subtotal resection of a benign mixed meningioma followed by a course of radiotherapy. Five years later she developed a skull tumor which was resected. Histological study showed sarcomatous change corresponding most likely to a postirradiation osteosarcoma. Adjuvant chemotherapy (methotrexate, carboplatin, and VP16) was given. A progression occurred 8 months later and the patient was treated unsuccessfully with tamoxifen, LHRH, and later with high dose methotrexate and carboplatin. Six months later a lung metastasis was discovered and she received four cycles of IVP (ifosfamide, vepeside, cisplatin) alternating with IVA (ifosfamide, vepeside, adriamycin). Within 4 months the primary and lung tumours had decreased substantially without evidence of progression at follow-up 5 months later. We conclude that IVP/IVA regimen is a potentially useful therapy when an osteosarcoma of the skull is in progression.

[Stage I and II Hodgkin's disease with enlarged mediastinum in adults. Apropos of 24 cases]. / Maladie de Hodgkin stade I et II à gros médiastin de l'adulte. A propos de 24 cas.

We have reported a retrospective study on 24 cases of supra-diaphragmatic Hodgkin's disease Stage I and II, with massive mediastinal invasion, followed from January 1981 to October 1986 and treated first with chemotherapy and then supra-diaphragmatic mantle type radiotherapy up to a dose of 40 Gy in 20 sessions and over 26 days; inverted irradiation was given to the aorto-lumbar region and the spleen up to a dose of 30 Gy in 15 sessions over 19 days. Supplementary irradiation to the superior mediastinum on average 10 Gy in five sessions over five days was given in two cases and five Gy in three sessions over three days in four cases. After initial chemotherapy there appeared to be a complete remission in 29% (7 out of 24), there was a partial remission in 71% (17 out of 24), of which one gave a 25% response, two a 50% response and 14 gave a response of greater than 80%. After radiotherapy the remission rate appeared complete in 96% (23 out of 24). The overall survival was 90% (19 out of 21) with a mean follow up of 45 months (range 8-78 months) with a complete remission level of 85.5% (18 out of 21). For the 13 cases followed for five years the overall survival level and the level of survival in complete remission was 84.5% (11 out of 13) and 77% (10 out of 13) respectively. We have seen symptomatic post radiotherapy pneumonia. The association of chemo and radiotherapy in this limited series of patients has enabled us to obtain a satisfying duration of remission.(ABSTRACT TRUNCATED AT 250 WORDS)