Anterior intratumoural chemotherapy: a newer modality of treatment in advanced solid tumours in children.
OBJECTIVE
Advanced and inoperable solid tumours in children have high mortality despite aggressive multimodal treatment. Intravenous chemotherapy is abandoned at times because of systemic toxicity. This study investigated intratumoural chemotherapy and compared it with intravenous chemotherapy.


METHODS
Forty children with advanced inoperable solid tumours (Wilms' tumour and neuroblastoma) were randomly allocated into two groups of 20. Group A was given intratumoural chemotherapy and group B was given intravenous chemotherapy. Both groups were compared for reduction in tumour size and volume, tumour resectability, histopathological changes and drug side effects.


RESULTS
Intratumoural chemotherapy was superior to intravenous chemotherapy in terms of reducing tumour size and volume (63% in group A vs. 22% in group B). The resectability was 70% in the intratumoural group compared with 40% in the intravenous group. The overall good histopathological response was 71% in group A as opposed to 0% in group B. Moreover, the incidence and severity of drug side effects and morbidity were less with intratumoural chemotherapy. Mortality was also low in group A (5%) compared to group B (20%).


CONCLUSIONS
Intratumoural chemotherapy can be offered as an effective and safe alternative treatment modality for advanced and inoperable Wilms' tumour and neuroblastoma.
Gangopadhyay
A N
AN
Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. gangulybhu@rediffmail.com
Rajeev
Rahi
R
Sharma
S P
SP
Upadhyaya
Vijai D
VD
Arya
N C
NC
Kumar
Vijayendra
V
Gopal
S C
SC
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002648:Child; D006801:Humans; D015552:Injections, Intralesional; D007275:Injections, Intravenous; D009447:Neuroblastoma / Q000188:drug therapy* / Q000473:pathology; D009396:Wilms Tumor / Q000188:drug therapy* / Q000473:pathology
D000970:Antineoplastic Agents