Metastatik Nüks Osteosarkomda Sorafenib Kullanımı: Olgu Sunumu

Year 2022, Volume: 3 Issue: 1, 40 - 44, 12.03.2022

Hatice Mine Çakmak , Yaşar Bildirici , Funda Çorapcıoğlu , Harzem Özger Ayten Kayı Cangır Meral Bahar

https://doi.org/10.48176/esmj.2022.55

Abstract

Nüks metastatik osteosarkomda birincil tedavi metastatik ve nüks tüm lezyonların cerrahi rezeksiyonudur. Nüks osteosarkomda ifosfamid, gemsitabin-docetaxel, VOİT (vinkristin-irinotekan-temozolamid, bevacizumab) verilebilmektedir. Seçili olgularda radyoterapi de uygulanmaktadır. Tirozin kinaz inhibitörlerinden, pazopanib ve sorafenibin refrakter osteosarkomda etkinliği gösterilmiştir. Bu vaka sunumunda, primer bölge nüksünde de radyoterapi sonrası ekstremite koruyucu cerrahi yapılan, sonrasında sırasıyla ifosfamid-doksorubisin, yüksek doz metotreksate, ifosfamid alan, akciğer metastatektomisi sonrası 6 kür VOİT alan, pazopanibi tolere edemeyen ve sorafenib ile idame tedavisi yapılan olgu sunulmaktadır. Olgu, son kemoterapiden sonra sekiz aydır remisyondadır. Sorafenib, nüks riski yüksek olan, remisyon sağlanan olgularda, mikroskopik rezidüel hastalık için güvenle bir yıl verilebilir.

Keywords

relaps,, metastaz,, çocuk,

Sorafenib as a maintenance therapy in an adolescent with relapsed-metastatic osteosarcoma

Abstract

The mainstay treatment for recurrent metastatic osteosarcoma is surgical resection of all metastatic and recurrent lesions. Ifosfamide, gemcitabine-docetaxel, VOIT (vincristine-irinotecan-temozolamide, bevacizumab) can be given in relapsed osteosarcoma. Radiotherapy is also applied in selected cases. The efficacy of tyrosine kinase inhibitors, pazopanib, and sorafenib, has been demonstrated in refractory osteosarcoma. In this case report, a case who underwent ten days radiotherapy and limb-sparing surgery in primary site recurrence, followed by ifosfamide-doxorubicin, high-dose methotrexate, and ifosfamide, received 6 cycles of VOIT after lung metastasectomy, could not tolerate pazopanib, and was treated with sorafenib as a maintenance treatment is presented. The case has been in remission for eight months after the last chemotherapy. Sorafenib can be safely given for one year for microscopic residual disease in remission-remitting patients with a high risk of relapse

Keywords

relapses, metastases, osteosarcoma, children, sorafenib, pazoponib, relapses, metastases, osteosarcoma, children, sorafenib, pazoponib

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