Rhabdomyosarcoma, chemotherapy

The treatment of Hodgkin s disease also illustrates the use of combined modalities, that is, radiation plus chemotherapy. The combined modality approach to several childhood tumors (e.g., Ewing s sarcoma, Wilms tumor, and rhabdomyosarcoma) has dramatically increased the cure rates for these diseases. 

Therapeutic modalities in cancer treatment may involve surgery, radiation, and/or chemotherapy. The objectives of cancer chemotherapy include (1) cure, (2) reduction in tumor size, and (3) prolongation of life. At the present time, approximately 50 percent of patients with cancer can be cured, with drug treatment estimated to contribute in 17 percent of cases. Cancer chemotherapy can be curative in testicular cancer, diffuse large cell lymphoma, Hodgkin s disease, choriocarcinoma, certain childhood tumors (acute lymphoblastic leukemia, Burkitt s lymphoma, Wilms tumor, and embryonal rhabdomyosarcoma). Certain cancers are more resistant to chemotherapy than others (e.g., lung and colon). 

Ortega, J.A., Donaldson, S.S., Ivy, S.P., Pappo, A., Maurer, HJM. Venoocclusive disease of the liver after chemotherapy with vincristine acti-nomycin D, and cyclophosphamide for the treatment of rhabdomyosarcoma a report of the intergroup rhabdomyosarcoma study group. Cancer 1997 79 2435-2439... 

A 12-year-old boy with prostatic rhabdomyosarcoma had episodes of syncope periodically over 7 months while taking fluconazole for chemotherapy-induced mucositis. He had taken fluconazole in the past without problems but had also taken a stable dose of amitriptyline for neuropathic pain. On withdrawal of amitriptyline he had no further episodes. The effect was confirmed by re administration. 

A few years ago significant palliative results were obtained by chemotherapy in a number of human neoplasma. Today it is, however, possible to list at least certain neoplastic diseases that can be associated with a normal life expectancy after treatment with drugs alone or in combination with other modalities. These neoplasms essentially include carcinoma in women, acute leukemia, Burkitt s lymphoma, Ewing s sarcoma, retinoblastoma in children, lymphosarcoma, Hodgkin s disease, rhabdomyosarcoma, mycosis ftmgoides and testicular carcinoma. 

As on data nearly ten diflfemet types of neoplasms may be cured with the aid of chemotherapy in patients quite satisfactorily, namely leukemia in children, Hodgakin s disease, Burkitt s lymphoma, Ewing s sarcoma, choriocarcinoma in women, lymphosarcoma, mycosis fimgoides, rhabdomyosarcoma, testicular carcinoma, and retinoblastoma in children. 

Chemotherapy, on its own, has proved effective in the following conditions. In choriocarcinoma, a womb tumour of young, pregnant women who used to suffer 90% mortality within a year but now have a 90% chance of complete cure, thanks to selectively toxic drugs in Burkitt s lymphoma of children in Africa, in testicular and ovarian cancer, in bone cancers (including rhabdomyosarcoma, Ewing s sarcoma, osteogenic sarcoma), muscle cancers, histiocytic lymphoma. 

Soon after clinical impact of these phytochemicals in curative and palliative cancer chemotherapies, a number of studies focused on design of their semisynthetic derivatives were developed. These efforts led to important anticancer agents, including vindesine (21), vinorelbine (22), and vinilunine (23). Vinorelbine has been administered for treating non-smaU ceU lung cancer (NSCLC), metastatic breast cancer, and rhabdomyosarcoma [98], Vindesine is usually used to treat leukemia, lymphoma, melanoma, and breast and lung cancers. Vinflunine is a fluoiinated vinblastine derivative and has been submitted to phase III clinical studies in patients with NSCLC and bladder cancer [99]. 

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