Vinorelbine+cyclophosphamideによる低侵襲外来治療にて長期無増悪生存を維持している中枢神経系原始神経外胚葉性腫瘍の1例

植村 優; 宮田 憲二; 矢内 友子; 齋藤 敦郎; 横井 健人; 二野 菜々子; 高藤 哲; 神前 愛子; 石田 敏章; 長谷川 大一郎; 川崎 圭一郎; 河村 淳史; 長嶋 達也; 副島 俊典; 赤坂 好宣; 吉田 牧子; 小川 淳; 小阪 嘉之

doi:10.11412/jspho.53.481

Case Report

Successful treatment of refractory central nervous system primitive neuroectodermal tumor with vinorelbine and cyclophosphamide as salvage therapy

Suguru Uemura, Kenji Miyata, Tomoko Yanai, Atsuro Saito, Takehito Yokoi, Nanako Nino, Satoru Takafuji, Aiko Kozaki, Toshiaki Ishida, Daiichiro Hasegawa, Keiichiro Kawasaki, Atsufumi Kawamura, Tatsuya Nagashima, Toshinori Soejima, Yoshinobu Akasaka, Makiko Yoshida, Atsushi Ogawa, Yoshiyuki Kosaka

Author information

Suguru Uemura
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Kenji Miyata
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Tomoko Yanai
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Atsuro Saito
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Takehito Yokoi
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Nanako Nino
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Satoru Takafuji
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Aiko Kozaki
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Toshiaki Ishida
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Daiichiro Hasegawa
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Keiichiro Kawasaki
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital
Atsufumi Kawamura
Department of Neuro Surgery, Children’s Cancer Center, Kobe Children’s Hospital
Tatsuya Nagashima
Department of Neuro Surgery, Children’s Cancer Center, Kobe Children’s Hospital
Toshinori Soejima
Department of Radiology, Children’s Cancer Center, Kobe Children’s Hospital
Yoshinobu Akasaka
Department of Radiology, Children’s Cancer Center, Kobe Children’s Hospital
Makiko Yoshida
Department of Pathology, Children’s Cancer Center, Kobe Children’s Hospital
Atsushi Ogawa
Department of Pediatrics, Niigata Cancer Center Hospital
Yoshiyuki Kosaka
Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital

Keywords: CNS-PNET, salvage therapy, vinorelbine, cyclophosphamide

JOURNAL FREE ACCESS

2016 Volume 53 Issue 5 Pages 481-486

DOI https://doi.org/10.11412/jspho.53.481

Details

Abstract

An 11-year-old boy was transferred to our hospital because of headache and nausea. Cephalic MRI revealed a tumor in the left frontal lobe. Tumorectomy with subtotal removal was performed. A histopathological diagnosis of central nervous system primitive neuroectodermal tumor (CNS-PNET) was carried out. Chemo-radiotherapy followed by high-dose chemotherapy with stem cell rescue was conducted. However, the tumor increased in size. As severe paralysis was a concern, surgery was not indicated. Therefore, outpatient chemotherapy with vinorelbine and cyclophosphamide was started. There were no serious adverse events except for grade 3 peripheral neuropathy and grade 4 neutropenia, which required dose reduction of VNR. Subsequently, he has been well without CNS-PNET progression. The efficacy of VNR for solid tumors in children has been internationally reported. No standard treatment for refractory or relapsed CNS-PNET has been established. Further studies are needed to improve the outcome of refractory or relapsed CNS-PNET.

Corresponding author

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