Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
183 Doctors are Online

Diagnosed with PNET-ewings sarcoma. What is the best treatment available?

User rating for this question
Very Good
Answered by
Practicing since : 2006
Answered : 101 Questions
Question
My queirey is particularly for Dr XXXXXXX ,Oncologist from USA.,my neice XXXXXXX 13yrs female was diagnoised with PNET-ewings sarcoma in XXXXXXX 2011.details have been given in medical history.and also we have attached her reports along with the pet scans.doctor kindly gives the best options available to treat her.she is physically fit and going to school daily.she can travell any where presently and we are ready to go any extent to treat her.currently she is on her first cycle of salvage chemotherapy(details in the medical history column).
Posted Thu, 8 Nov 2012 in Cancer
 
 
Answered by Dr. Ioan Dorian OANA 2 days later
Hello,

Thanks for your query.

I have studied your niece's case carefully and I have discussed it with other colleagues which have more experience in treating PNET-ewing sarcoma (because this disease is very rare), this is why I needed a little more time to give you an opinion. We have concluded that we would have run exactly the same treatment as her doctor has done it. I understand completely your desire to go any extent to treat her, but unfortunately the prognostic is very poor.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with PNET-ewings sarcoma. What is the best treatment available? 16 days later
Dear doctor.this is in continuation to my quiry dt 29th sept reagarding my niece XXXXXXX diagnoised with pnet with lung matastatis.she was treated with surgery,chemo & radiation .at the end of the treatment her pet scan revealed no tumour at the sites initially diagnised but they havr metastatised to her bilateral lungs.she is on salvage chemotherapy..in the 1st cycle she was given topotecan and cyclophosphamide.but after 15 days her lungs got filled with fluid and the cytological report of the fluid states haemorregic pleural effluence with small round sarcoma cells.
Doctors are of the opinion that topotecan and cyclophosphamide may not have worked and cant take a chance with same drugs for the second cycle.so they have advised to change drugs.our treating doctor has adviced to go with GEMCITABINE & DOCETAXEL.since these both have not been introduced to her body.but i went to another prestegious hospital AIIMS where the doctor is of the opinion that IFOSFAMIDE & CORBOPLATIN with ETOPOSIDE (ICE) is some what better and said that ig were the treating doctor he would have gone with ICE CHEMO.but our treating doctor says since she has already been given ifosfamide & etoposide( only carboplatin not given) he wants go with grmcitabine and doxotexal.now we are in a dielama that we have already lost one cycle and we are only left with 3 cycles.doctor i request you to kindly discuss this issue with the Ewings specialist as you did previously and kindly let us know which combination had better chance of response.we have 4 more days for the next cycle.we shall be greatfull if you could come up with an answer.
Warm regards XXXXXXX XXXXXXX
 
 
Answered by Dr. Ioan Dorian OANA 3 hours later
Hello,

Thanks for your query.

In this situation I cannot say there is a correct option and a wrong option, but if If I would be the treating doctor, I would gone with GEMCITABINE & DOCETAXEL, even if the patient would have not received IFOSFAMIDE & ETOPOSIDE already.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with PNET-ewings sarcoma. What is the best treatment available? 11 hours later
Thanks for your kind reply doctor..can you kindly let me know if any clinical trials is going on for ewings anywhere..
 
 
Answered by Dr. Ioan Dorian OANA 10 hours later
Hello,

Thanks for your query.

You should contact M.D. XXXXXXX Cancer Center, because they run a clinical trial for patients with diagnosis of lung metastases. Often these are sarcoma patients and the goal of this clinical research study is find the highest tolerable dose of interleukin-2 (a protein that triggers white blood cells, called natural killer cells or T-cells, to kill cancer cells) that can be given as an inhaled mist to patients with lung metastases.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with PNET-ewings sarcoma. What is the best treatment available? 1 hour later
Thanks a lot doctor.we have already approached for an appointment at md XXXXXXX .doctor kindly let me know if the procedure that you have mentioned can be done even in between her chemo cycles (gemcitabine & docetaxel).because when we approched them they told us that they dont give any opinion online without evaluating the patient.our dielama is if we take her all the way to US & they also suggest the same chemo regime it will be criminal waste for us to take her all the way from india or if they say we should complete the chemo regime and then bring her again even that would be like a punishment for us.doctor can kindly advice on this matter.
Warm regards XXXXXXX XXXXXXX
 
 
Answered by Dr. Ioan Dorian OANA 41 minutes later
Hello,

Thanks for your query.

I am sure it is not possible to be done even in between her chemo cycles because one of the inclusion criteria is: at least 4 weeks since the last dose of chemotherapy. However I would recommend you to take her all the way to US because they have to evaluate the patient and I am sure there is not a better place for her condition than this center. However I cannot avoid telling you that the current situation is very bad and in my opinion even there the prognosis remains poor.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Drug/Medication
Treatment/Therapy

The user accepted the expert's answer

Ask an Oncologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor