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BMJ Case Rep ; 20182018 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-29866686

RESUMO

An adolescent patient diagnosed with disseminated abdominal desmoplastic small round cell tumour (DSRCT) was taken up for systemic chemotherapy, debulking surgery, stem cell transplant followed by whole abdominopelvic radiotherapy using intensity-modulated radiotherapy. Following this, the patient developed multiple episodes of small bowel obstruction, a known complication of abdominal surgery and radiotherapy. The patient expired due to the complications of bowel obstruction 13 months after the completion of radiotherapy. Though we managed to achieve a complete response at the disease sites with an aggressive therapeutic approach, the patient eventually succumbed to treatment-induced morbidity. Large prospective trials to define management guidelines taking into account quality of life issues may not be feasible for a rare and aggressive scenario such as DSRCT. Therefore, case reports and series reporting not just the treatment techniques and survival, but also the resultant toxicities, will make us vigilant when choosing the intensity of its treatment.


Assuntos
Neoplasias Abdominais/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Procedimentos Cirúrgicos de Citorredução/efeitos adversos , Tumor Desmoplásico de Pequenas Células Redondas/terapia , Obstrução Intestinal/etiologia , Intestino Delgado , Complicações Pós-Operatórias/etiologia , Lesões por Radiação/etiologia , Radioterapia de Intensidade Modulada/efeitos adversos , Transplante de Células-Tronco/métodos , Aderências Teciduais/complicações , Adolescente , Evolução Fatal , Humanos , Masculino , Terapia Neoadjuvante , Órgãos em Risco , Radio-Oncologistas , Planejamento da Radioterapia Assistida por Computador
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