Novel treatment of Refractory/recurrent Pulmonary Hepatoblastoma.Pediatr Int 2019PI
There is no consensus about how to manage pulmonary metastasis in patients with hepatoblastoma. Here, among our institution, we reviewed a treatment with a combination of Oxaliplatin/Vincristine/Topotecan(OVT) paired with radiofrequency ablation (RFA) of twelve patients with multiple refractory/recurrent pulmonary hepatoblastoma(HB).
The medical records from patients with≤ 21 years of age presenting of multiple deposits (≥2) of refractory/recurrent pulmonary HB were reviewed. The following data were extracted from each patient, age, gender, histological subtyping, cycles of OVT, tumor size, biomarkers, chemotherapy regimen and dosage, RFA details, treatment response, follow up and patient outcomes. The primary outcome measure was the rate of complete response of pulmonary diseases, and secondary outcomes were event-free survival rate and overall survival rate.
Of twelve assessable patients, three (25%) (95%CI, 46.3% to 104%) patients achieved PR after they finished OVT. After RFA, five (41.7%) (95%CI, 8.95% to 74.4%) patients achieved CR. The 2-year EFS was 33% (95%CI, 20.5% to 64.6%). The 2-year OS for the study group was 41.7% (95%CI, 8.9% to 74.4%). All toxicity events were handled satisfactorily and no toxic related death were observed.
Our review report shows that OVT combined with RFA can be a successful treatment modality for previously heavily treated refractory/recurrent pulmonary metastatic lesions from hepatoblastoma.