title: Caffeine-potentiated chemotherapy for clear cell sarcoma: a report of five cases.
abstract: BACKGROUND
  Clear cell sarcoma is a rare malignant tumor of soft tissue which is most commonly encountered in the extremities, especially in the foot and ankle. This tumor is slow-growing and looks like a benign tumor; it is therefore often treated inadequately and its high rate of recurrence and metastases results in a poor prognosis. Caffeine has been used as a chemotherapy potentiator that inhibits DNA damage repair and enhances the cytocidal effects of anti-cancer drugs. This study reports the effect of caffeine-potentiated chemotherapy for clear cell sarcoma in five patients.
  
  
  METHODS
  Caffeine-potentiated chemotherapy was administered to five patients with clear cell sarcoma. Three to five courses of intra-arterial chemotherapy using cisplatin, doxorubicin and caffeine were administered preoperatively, at 3-week intervals. Conservatively, wide margin surgery was performed following the preoperative chemotherapy. Intravenous cisplatin and doxorubicin with caffeine were administered three to six times to the patients who responded to the preoperative chemotherapy. This study evaluated the response to chemotherapy, recurrence, metastasis and the overall prognosis in these five patients.
  
  
  RESULTS
  Four of the eligible patients responded to preoperative chemotherapy. Local recurrence occurred in only one of the five patients. Distant metastasis newly developed in one patient. All five patients survive.
  
  
  CONCLUSIONS
  Caffeine-potentiated chemotherapy can be effective treatment for clear cell sarcoma not only as initial therapy, but also as salvage therapy.
authors: Department of Orthopaedic Surgery, Koseiren Namerikawa Hospital, 119 Tokiwa-cho, Namerikawa, 936-8585, Japan.
authors: Michiaki
authors: M
authors: Karita
authors: Hiroyuki
authors: H
authors: Tsuchiya
authors: Norio
authors: N
authors: Yamamoto
authors: Toshiharu
authors: T
authors: Shirai
authors: Katsuhiro
authors: K
authors: Hayashi
authors: Hideji
authors: H
authors: Nishida
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002110:Caffeine / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D004249:DNA Damage / Q000187:drug effects; D004260:DNA Repair / Q000187:drug effects; D005121:Extremities / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018227:Sarcoma, Clear Cell / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002110:Caffeine; D002945:Cisplatin