Successful Treatment of Infantile Fibrosarcoma Spinal Metastasis by Chemotherapy and Stereotactic Hypofractionated Radiotherapy

Abstract

We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife® stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

Efficacy and Safety of Chemotherapy Combined with Stereotactic Radiotherapy in the Treatment of Nasopharyngeal Carcinoma

“…In addition, it was also found in the study that although toxicity occurred in all groups of patients, no statistically important difference was found in toxicity among the three groups receiving CT, SRT, and CT combined with SRT, showing that combined treatment could lead to better results without exacerbating toxicity. Also, Lo et al [ 25 ] demonstrated that chemotherapy combined with SRT, in accordance with ours, reduced tumor size without acute radiation toxicity even after 33 months, and regarded it as a secure alternative for cancer treatment.…”

Core Biopsy Diagnosis of Infantile Fibrosarcoma: Case report

“…BED=nd (1+ d ) α/β [2] Surgery has traditionally been considered the treatment Of choice for IFS. The radicality of first surgery, aimed at achieving histopathologically negative margins, is associated with best prognosis.…”

Primary mediastinal infantile fibrosarcoma: An unusual presentation involving the thymus

“…It is an intermediate‐grade sarcoma with 5‐year survival rates ranging from 80 to 100% and rare recurrence 2 . A majority of IFS have an ETV6‐NTRK3 fusion resulting from an ETV6 translocation on chromosome 12, 6,7 allowing for cytogenetic diagnosis. We report an unusual case of mediastinal IFS with thymic involvement treated with neoadjuvant chemotherapy and surgery.…”

“…Chemotherapy approaches for IFS in the mediastinum and thymus have not been described but represent a viable option. Radiotherapy has also been described as a therapeutic modality but should be utilized with caution due to deleterious effects on the growth plate and its association with secondary malignancies 6 . Recently, tropomyosin receptor kinase inhibitors have emerged as a neoadjuvant option in locally advanced tumors with TRK fusions with early efficacy data in children 12 …”