An adolescent patient diagnosed with disseminated abdominal desmoplastic small round cell tumour (DSRCT) was taken up for systemic chemotherapy, debulking surgery, stem cell transplant followed by whole abdominopelvic radiotherapy using intensity-modulated radiotherapy. Following this, the patient developed multiple episodes of small bowel obstruction, a known complication of abdominal surgery and radiotherapy. The patient expired due to the complications of bowel obstruction 13 months after the completion of radiotherapy. Though we managed to achieve a complete response at the disease sites with an aggressive therapeutic approach, the patient eventually succumbed to treatment-induced morbidity. Large prospective trials to define management guidelines taking into account quality of life issues may not be feasible for a rare and aggressive scenario such as DSRCT. Therefore, case reports and series reporting not just the treatment techniques and survival, but also the resultant toxicities, will make us vigilant when choosing the intensity of its treatment.
- paediatric oncology
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Contributors Both the authors declare that they have participated in the design and drafting of the paper, and that they have approved the final version. Individual contributorship is as follows: AKP did the radiotherapy contouring, designing, writing of the manuscript and review of literature. MSM did the radiotherapy plan, its quality assurance and provided the necessary technical inputs for drafting 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 Not required.
Provenance and peer review Not commissioned; externally peer reviewed.