Biomedical subjects

Scott Schuetze

Publications and source records attributed to Scott Schuetze.

4 recordsLinked to original sources

PubMed2006

Complications of a temozolomide overdose: a case report.

PURPOSE AND BACKGROUND: This is a report of a 53 year-old man with a glioblastoma multiforme (GBM) treated with an excessive dose of temozolomide (TMZ). METHODS: This is a single case review of all clinically relevant records. O6-methylguanine-DNA methyltransferase activity was determined by a biochemical assay. RESULTS: Following conventional radiotherapy (RT) without concurrent chemotherapy, the patient received 5,500 mg of TMZ over 2 days. At the standard dose of 200 mg/m2/day his total 5-day dose should have been 1,940 mg. Acutely he had nausea, vomiting and diarrhea for 2 days which cleared. The dominant severe toxicity was pancytopenia between one and four weeks after TMZ which was complicated by secondary infections that were successfully managed. Transient transaminitis occurred but there were no significant pulmonary, renal or other systemic toxicities. His progression free survival was 22 months and overall survival 24 months. CONCLUSION: His outcome suggests that TMZ may prove to be a good agent for dose-escalation trials with hematopoietic stem cell rescue.

Antineoplastic Agents, Alkylating↗

PubMed2004

Influence of age upon Ifosfamide-induced nephrotoxicity.

BACKGROUND: Ifosfamide-induced nephrotoxicity is well recognized in children, although it has also been reported in adults. Whether ifosfamide nephrotoxicity is more common in children than in adults is not known. PROCEDURE: Medical records of adults and children diagnosed with sarcoma whom received ifosfamide with a cumulative dose >20 g/m(2) were evaluated. Twenty-five children (</=18-years of age) and 28 adults were identified. RESULTS: National Cancer Institute Common Toxicity Criteria grade 3-4 ifosfamide-induced nephrotoxicity was present in 24 and 17% of children and adults, respectively (P = 0.58). Cumulative ifosfamide doses were similar between the two populations, with the median (range) of 70.2 g/m(2) (22.4-72) for children and 59 g/m(2) (20.8-146) for adults (P = 0.25). Logistic regression analysis indicated that neither age or cumulative ifosfamide dose were associated with grade 3-4 ifosfamide-induced nephrotoxicity (P = 0.36). CONCLUSIONS: Children and adults receiving >20 g/m(2) of ifosfamide have similar susceptibility to ifosfamide-induced nephrotoxicity. Factors other than age and cumulative dose should be considered for understanding the inter-individual variation in nephrotoxicity.

Adolescent↗

PubMed2003

FDG PET imaging guided re-evaluation of histopathologic response in a patient with high-grade sarcoma.

[(18)F]fluorodeoxyglucose positron emission tomography (FDG PET) is used to evaluate the metabolic activity of intermediate- to high-grade soft tissue sarcomas prior to the initiation of chemotherapy. FDG PET and MRI are repeated after chemotherapy to assess treatment response and to correlate this with the histologic response. This case report highlights discrepant results between the final histologic diagnosis (tumor response) and the percent change in maximum standard uptake variable (SUV(max)). Further investigation of the resected specimen identified the significant difference in tumor response assessment to be due to the heterogeneity of the tumor and heterogeneity in its response to treatment. FDG PET imaging has an important role in evaluating tumor metabolic activity and has played an increasingly important part in evaluating the response to neoadjuvant chemotherapy in sarcomas. Evaluating the heterogeneity of the tumor at baseline and after response to therapy can provide insight into prognosis and treatment planning.

Chemotherapy, Adjuvant↗

PubMedDate not supplied

Angiosarcoma metastatic to the orbit.

A 61-year-old woman developed metastatic angiosarcoma in her left orbit. Diagnosis was confirmed with an incisional orbital biopsy and special markers. Treatment and palliation involved the use of multiple cycles of paclitaxcel, doxorubicin, and ifosfamide along with adjuvant radiotherapy. The measured outcome was tumor mass reduction and mortality. Angiosarcoma was confirmed with histologic analysis. The patient responded to the chemotherapy with reduction of the tumor mass. However, the disease progressed off the medications. She finally died. However, she survived longer than the patient in the only other similar case report. Chemotherapy may be a useful palliative adjunct in the control of metastatic orbital angiosarcoma. Chemotherapy is unlikely to be curative but useful and an adjunct to surgery and radiation therapy.

Biopsy↗