Hyperthermic intraperitoneal chemotherapy (HIPEC) as another treatment modality for desmoplastic round cell tumour patients: first paediatric experience from UK

BMJ Case Rep. 2021 Jan 28;14(1):e234876. doi: 10.1136/bcr-2020-234876.

Abstract

We present the first young paediatric patient with desmoplastic small round cell tumour (DSRCT) treated in UK with hyperthermic intraperitoneal chemotherapy (HIPEC). A 7-year-old girl was diagnosed with abdominal DSRCT with peritoneal and liver metastases. After six cycles of chemotherapy she obtained a partial response, including almost complete resolution of the two liver metastases. It was decided to pursue cytoreductive surgery (CRS) combined with HIPEC, a procedure commonly performed in adults, but seldom in a child. The surgery was macroscopically complete and the HIPEC uncomplicated. She continued treatment without delays, including whole abdomino-pelvic radiotherapy and maintenance chemotherapy (cyclophosphamide/vinorelbine for 12 months). She is currently in complete remission 4 months after end of treatment and 26 months after diagnosis. HIPEC was made possible by successful collaboration between multiple teams. CRS-HIPEC proved to be safe and feasible and could be offered to other children with diagnoses of peritoneal malignancies across the UK.

Keywords: malignant disease and immunosuppression; paediatric oncology; paediatrics (drugs and medicines).

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Cisplatin / administration & dosage*
  • Cyclophosphamide / administration & dosage
  • Cytoreduction Surgical Procedures / methods*
  • Desmoplastic Small Round Cell Tumor / diagnostic imaging
  • Desmoplastic Small Round Cell Tumor / secondary
  • Desmoplastic Small Round Cell Tumor / therapy*
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Hyperthermic Intraperitoneal Chemotherapy / methods*
  • Ifosfamide / administration & dosage
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy*
  • Maintenance Chemotherapy
  • Neoadjuvant Therapy
  • Pelvic Neoplasms / diagnostic imaging
  • Pelvic Neoplasms / pathology
  • Pelvic Neoplasms / therapy*
  • Peritoneal Neoplasms / diagnostic imaging
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / therapy*
  • Radiotherapy / methods
  • Remission Induction
  • United Kingdom
  • Vincristine / administration & dosage
  • Vinorelbine / administration & dosage

Substances

  • Antineoplastic Agents
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Cisplatin
  • Vinorelbine
  • Ifosfamide