Background. The effectiveness of adjuvant chemotherapy in soft tissue sarcomas remains a matter of controversy. The authors reviewed their experience with 14 patients with localized disease treated with intensive doxorubicin‐cisplatin‐ifosfamide‐based chemotherapy.
Methods. Fourteen patients with newly diagnosed nonmetastatic synovial sarcoma seen between 1985 and 1992 received intensive chemotherapy and local radiation therapy before surgical resection, followed in most patients by intensive postoperative chemotherapy. Chemotherapy included high‐dose cisplatin and doxorubicin or high‐dose ifosfamide (14 g/m2) and cisplatin with doxorubicin.
Results. One (7%) patient had a local recurrence during the study interval and remains free of disease 35 months after re‐excision and a second course of intensive chemotherapy. All other 13(93%) patients remained continuously free of disease after a median follow‐up of 37 months (range, 6–85 months). There were no deaths. General toxicity was the reason cited by seven patients who elected not to receive postoperative chemotherapy. For the remaining seven patients who elected to continue treatment, there were only two hospitalization admissions for neutropenia and fever. There was no significant cardiotoxicity, nephrotoxicity, or neurotoxicity.
Conclusion. Additional studies using new intensive systemic adjuvant therapies are needed to determine whether the encouraging results of this experience can be translated into prolonged disease‐free and overall survival.
An unusual case of Merkel cell carcinoma is presented in which the time course to development of nodal and haematogenous metastases was protracted and the predominant site of metastatic disease was small bowel. C. The role of radiotherapy in the management of primary cutaneous neuroendocrine tumours (Merkel cell or trabecular carcinoma): Experience at the Peter Mac-Callum Cancer Institute (Melbourne, Australia). Int. J. Radial. Oncol. Biol. Phys. Redmond J, Perry J, Sowray P, Vukelja SJ, Dawson N. Chemotherapy of disseminated Merkel cell carcinoma. Am. J. Clin. Oncol. 1991; 14: 305-7. Morrison WH, PetersLJ, SilvaEG, Wendt CD, Ang KK, Goepfert H. The essential role of radiation therapy in securing locoregional control of Merkel cell carcinoma. l n~. J. Radiar. Oncol. B i d . Phys. 847-50. J. Surg. 1988; 58: 97 1-4.
The carcinoid syndrome and fibrosis are unusual but identifiable disease processes. We report a rare case of retroperitoneal fibrosis associated with an ileal carcinoid in the absence of metastatic disease. The literature is reviewed.
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