Tag Archives: chemotherapy

Renal Ewing sarcoma with extensive neuroectodermal differentiation: Case report and literature review

DOI: 10.2478/amma-2023-0034

Ewing sarcoma with renal localization is one of the rarest members of the Ewing sarcoma family with less than 200 cases reported in the Medline database. Considering the fact that the majority of data published on the Ewing sarcoma with neuroectodermal differentiation is obtained through a few case reports and case series, it becomes understandable why we currently have no universally accepted treatment regimens.
Case summary: A 33-year-old patient presented to the Emergency Department with right lumbar pain following a mild trauma and an episode of macroscopic hematuria. Physical examination confirmed hematuria and flank pain and a palpable flank mass was identified. MRI showed a cystic lesion of the upper pole of the right kidney of 127/110/123 mm. After prior agreement of the multidisciplinary team, a 3D laparoscopic right radical nephrectomy was done. The histopathological diagnosis revealed an Ewing sarcoma with extensive neuroectodermal differentiation staged as pT3N1M0L1V2R0. Despite swift implementation of the chemotherapy protocol, the progression of the disease was quickly noted. Currently, one year after diagnosis, the disease is still progressing despite the chemotherapy treatment, the patient being a third line chemotherapy candidate. As renal localization of Ewing sarcoma with extensive neuroectodermal differentiation is extremely rare, multimodal treatment strategies must be established by a multidisciplinary team. Despite its aggressive biological behavior, a proper therapeutic management might increase patient life expectancy.

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Remarks on Odontogenesis in Children After Chemo-radiation Therapy

Introduction: Leukemias are the most frequent forms of neoplasias in children. The oral complications that occur in time, after the specific treatment through chemotherapy or radiotherapy, are represented by the occurrence of multiple carious lesions, disorders of dental eruptions, the premature loss of the primary teeth, anomalies in the development of teeth.
Material and method: Through the clinical examination of the oral cavity and through radiological examination, with the help of the orthopantomogram, we revealed the disorders of dental development consecutive to the cytostatic therapy and radiotherapy in the acute lymphoblastic leukemia.
Results: The specific treatment through chemotherapy and radiotherapy overlapped with important stages of the physiological process of odontogenesis. We noted ageneses, microdontias, precocious eruptions and disorders of the eruption order.
Conclusions: The cytostatic medication and radiotherapy can be followed by anomalies in the development and eruption of the dental buds. The severity of these secondary effects varies according to the patient’s age at the moment of the start of the specific therapy, the stage of dental development, the type of cytostatic medication and the dose and frequency of treatment cycles.

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The Response to Chemotherapy as Prognostic Marker in Multiple Myeloma

Objectives: Even though the correlation between the degree of therapeutic response and overall survival was studied for a long time, there are still contradictory opinions. This study intends to evaluate the prognostic value of response to chemotherapy in terms of patient survival and depending on the type of therapy.
Material and method: The study analyses 110 patients diagnosed and treated between January 2006 and September 2012. Descriptive analysis of cases was performed and survival analysis was realised using Kaplan-Meier curves compared to logrank test.
Results: The median survival was 18 months when the patients were treated with vincristine + adriamycin + dexamethasone, 20 months with melphan + prednisone, 71 months with melphalan + cyclophosphamide + vincristine + prednisone (p = 0.020), 33 months with Bortezomib and 4 months with dexamethasone. A percent of 38.18% of patients responded near completely to therapy, partial response occurred in 29.09% of cases and no response/ refractory disease in 32.72%. The patients had a median survival of 62 months for near complete response to therapy, 20 months for partial response and 4 months for no response/ refractory disease (p < 0.0001). The time to disease progression was of 24 months regardless of the used therapy. The most common adverse effect was anaemia.
Conclusions: Lack of response to treatment is a negative prognostic factor in the evolution of multiple myeloma patients.

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