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Hyperthermic intraperitoneal chemotherapy (HIPEC) as another treatment modality for desmoplastic round cell tumour patients: first paediatric experience from UK
  1. Tomas Sjoberg Bexelius1,2,
  2. Julia C Chisholm3,4,
  3. Bruce Okoye5,
  4. Tom Cecil6,
  5. Paola Angelini3 and
  6. Sanjeev Dayal7
  1. 1Paediatrics, St George's University Hospitals NHS Foundation Trust, London, UK
  2. 2Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
  3. 3Paediatric Haemato-oncology, Royal Marsden Hospital NHS Trust, London, UK
  4. 4Unit for Sarcoma Clinical Trials in Children, ICR, Sutton, London, UK
  5. 5Department of Paediatric Surgery, St George's University Hospital, London, UK
  6. 6Basingstoke and North Hampshire Hospital, Peritoneal Malignancy Institute Basingstoke, Hampshire Partnership NHS Foundation Trust, Southampton, UK
  7. 7Peritoneal Malignancy Institute, Hampshire Hospital, Basingstoke, UK
  1. Correspondence to Dr Tomas Sjoberg Bexelius; tomas.s.bexelius{at}ki.se

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.

  • paediatrics (drugs and medicines)
  • malignant disease and immunosuppression
  • paediatric oncology

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Footnotes

  • Contributors TSB drafted the case report, reviewed the literature underlying the manuscript and has approved the manuscript’s final version. PA devised the case report, reviewed and wrote the manuscript and has approved the manuscript’s final version. PA was the primary responsible clinician for the patient that is described in the case report. BO was instrumental in the novel treatment of the patient and developed the manuscript along with the co-authors, and has provided significant input to the manuscript. BO has approved the final version of the manuscript. JCC reviewed the manuscript and contributed significantly to the writing of the manuscript. She also participated in the patient’s care as one of the key oncologist. JCC has approved the final version of the manuscript. SD and TC reviewed the manuscript and contributed significantly to the writing of the manuscript. SD also participated in the patient’s care as one of the experts of the novel treatment described in the case report. They both have approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.