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Connective Tissue Oncology Society |
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| 2002 CTOS Annual Meeting Oral Presentations — Medical Oncology UNEXPECTED
SEVERE TOXICITY OF LOW DOSE METOTHREXATE AND VINBLASTINE IN PATIENTS
WITH DESMOID TUMOURS Category: Medical Oncology Presentation: Oral Authors: Reginald van der Hul1, Bert van Geel1, Caroline Seynaeve1, Jaap Verweij1 Author Institutions: 1Erasmus Medical Center Rotterdam, Netherlands Presenter:
Bert van Geel Objectives: Evaluation
of tolerability of low dose chemotherapy for desmoid tumours. Methods: 10 patients
with desmoid tumours (six male; four female; median age 43 years
[17-75], median WHO performance score 0 [0-1]), for whom surgery
was considered to be severely mutilating, were treated with chemotherapy
consisting of weekly intravenous methotrexate 50 mg and vinblastine
10 mg, scheduled to be given for one year. This regimen has previously
been reported as active for desmoids and to be devoid of serious
toxicity. Toxicity was assessed using NCI-CTC criteria. If full
doses could not be given because of side effects the dose was either
reduced or the dose interval was extended, based upon the observed
type of toxicity. The reasons for preliminary termination of the
treatment regimen were registered. Results: No patient
could complete the treatment. In all cases dose reduction, delay
of dose interval or preliminary termination of the treatment was
necessary. All patients had nausea varying from grade I-III, despite
antiemetics. Four patients developed polyneuropathy (grade I-III),
four had continuous fatigue (grade I-II), two developed leucopenia
(grade II-III), two patients developed grade II-III impairment of
liver function. One patient developed reversible methotrexate induced
pulmonary fibrosis. One patient experienced a complete remission
lasting 26 months, eight had stable disease, and one progressed
on treatment. Six patients underwent surgery following chemotherapy.
Conclusions: Our experience indicates severe long term toxicity is related to this chemotherapy. This is in sharp contrast with a previous report. We believe the regimen can not be recommended for routine use outside study protocols.
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