Active chemotherapy for bone metastasis in sarcomatoid renal cell carcinoma.
Sarcomatoid renal cell carcinoma (SRCC) is associated with an aggressive course, high incidence of bone metastasis, and an extremely poor prognosis. There are a few case reports concerning the effectiveness of chemotherapy on metastasis in SRCC. To our knowledge, however, there are no reports describing its effectiveness on bone metastasis. We report a 22-year-old woman with an 8-cm x 7-cm left renal mass. Left nephrectomy was done. The pathological diagnosis was SRCC, INF-beta, pT3aN2. Although, she received continuous infusion of interferon alpha-2a (INFalpha-2a) and interleukin-2 (IL-2) as adjuvant therapy, liver metastasis appeared 2 months later. Resection of the liver metastasis was done. After resection of the metastasis, multiple bone metastases appeared, in both humeri, the left chest wall, the left fourth rib, and the left iliac bone. The patient was treated with gemcitabine, 1000 mg/m(2) (days 1, 8), docetaxel 80 mg/m(2) (day 1), and carboplatin 300 mg/m(2) (day 1). A computed tomography (CT) scan after the first cycle revealed that the multiple osteolytic bone tumors had significantly decreased in size. Her ability of daily life (ADL) improved and this continued for almost 2 months. A second course of chemotherapy, with gemcitabine and IL-2 was given, but it was ineffective, and the patient died approximately 16 months after the initial diagnosis of SRCC. Combination chemotherapy with gemcitabine, docetaxel, and carboplatin was effective for the bone metastasis of SRCC.
Hoshi
Senji
S
Department of Urology, Yamagata Prefectural Hospital, 1800 Aoyagi, Yamagata 990-2292, Japan. hoshi@uro.med.tohoku.ac.jp
Satoh
Makoto
M
Ohyama
Chikara
C
Hiramatu
Masayoshi
M
Watanabe
Ryuji
R
Hagisawa
Shigeru
S
Endo
Mareyuki
M
Arai
Yoichi
Y
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D016190:Carboplatin / Q000008:administration & dosage; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077143:Docetaxel; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012509:Sarcoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D043823:Taxoids; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000093542:Gemcitabine
D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D016190:Carboplatin; D017239:Paclitaxel; D000093542:Gemcitabine