RESUMO
Patients with high-risk neuroblastoma remain a therapeutic challenge with significant numbers of patients failing to respond sufficiently to initial therapy. These patients with poor response to induction are considered as ultra high-risk and are in need of novel treatment strategies. Isotretinoin is part of the standard of care treatment for patients with high-risk disease who undergo high-dose chemotherapy with autologous stem cell rescue although some have questioned the optimal administration schedule. Prolonged use of isotretinoin was well tolerated and may have contributed to long-term survival in a group of patients with ultra high-risk neuroblastoma.
Assuntos
Neoplasias das Glândulas Suprarrenais/tratamento farmacológico , Antineoplásicos/administração & dosagem , Ganglioneuroblastoma/tratamento farmacológico , Isotretinoína/administração & dosagem , Quimioterapia de Manutenção/métodos , Neuroblastoma/tratamento farmacológico , 3-Iodobenzilguanidina/uso terapêutico , Neoplasias das Glândulas Suprarrenais/terapia , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/secundário , Criança , Pré-Escolar , Terapia Combinada , Esquema de Medicação , Evolução Fatal , Feminino , Ganglioneuroblastoma/cirurgia , Transplante de Células-Tronco Hematopoéticas , Humanos , Isotretinoína/uso terapêutico , Masculino , Neuroblastoma/secundário , Neuroblastoma/terapia , Indução de Remissão , Risco , Transplante AutólogoRESUMO
Growth hormone deficiency (GHD) related to standard dose chemotherapy has rarely been described. We report on a case of localized ganglioneuroblastoma treated by carboplatin/etoposide for 2 courses and surgery, which developed a serious GHD after 56 months. At present, the child is growing on by GH replacement therapy. We discuss about the hypothesis that GHD may be related to chemotherapy and we report a review of previous published cases.