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Advances in Radiotherapy
& Nuclear Medicine Malignant peripheral nerve sheath tumor: A case report

Table 1. Some chemotherapy regimens suitable for 4. Conclusion
malignant peripheral nerve sheath tumors (Abstract from
NCCN Guidelines Version 3.2024) MPNSTs are rare soft-tissue sarcomas with non-specific clinical
and imaging characteristics. To decide the most appropriate
Treatment modalities Chemotherapy regimens treatment, integrating radiological findings and histological
Neoadjuvant/adjuvant • AI (doxorubicin, ifosfamide, and mesna) results is essential. In localized disease, a combination of
therapy • Ifosfamide, epirubicin, and mesna radical surgery and adjuvant radiotherapy or chemotherapy is
First-line therapy for • Anthracycline‑based regimens: recommended. Anthracycline-based cytotoxic chemotherapy
advanced/metastatic • Doxorubicin is the standard treatment for advanced and metastatic disease;
disease • Epirubicin however, it is often less effective.
• Liposomal doxorubicin
• AD (doxorubicin and dacarbazine)
• AI Acknowledgments
• Ifosfamide, epirubicin, and mesna The authors would like to thank the participating patients,
Subsequent lines of • Eribulin as well as the colleagues and nurses who made this work
therapy for advanced/ • Trabectedin possible.
metastatic disease • Gemcitabine and docetaxel
Funding
Table 2. Adverse effects of the doxorubicin–ifosfamide (AI) None.
regimen
Drugs Common adverse effects Conflict of interest
Doxorubicin • Cardiotoxicity: Doxorubicin causes heart damage and Phuong Cam Pham is an Editorial Board Member of this
arrhythmias due to the generation of free radicals, journal but was not in any way involved in the editorial
leading to oxidative stress that damages the membrane and peer-review process conducted for this paper, directly
of cardiomyocytes.
• Gastrointestinal toxicity: nausea, vomiting, mucositis, or indirectly. Separately, other authors declared that they
and diarrhea. have no known competing financial interests or personal
• Hematologic toxicity: Doxorubicin causes relationships that could have influenced the work reported
myelosuppression, leading to neutropenia, anemia, in this paper.
and an increasing risk of secondary cancers such as
leukemia. Author contributions
• Endocrinology and metabolism toxicity: high uric acid
levels. Conceptualization: Khoa Trong Mai, Phuong Cam Pham,
Ifosfamide • Urotoxicity: hemorrhagic cystitis, usually managed Thai Van Pham, Hien Quang Le
with intravenous infusion of mesna. Investigation: All authors
• Hematologic toxicity: similar to doxorubicin. Methodology: Phuong Cam Pham, Hien Quang Le
• Neurotoxicity: cognitive dysfunction, ifosfamide
encephalopathy, and peripheral neuropathy. Writing – original draft: Duong Binh Nguyen, Hoang The
• Falconi syndrome (rare). Tran
• Nausea and vomiting. Writing – review & editing: Phuong Cam Pham, Khoa
• Alopecia. Trong Mai, Thai Van Pham
• High liver enzyme levels.
Ethics approval and consent to participate
Table 1. The adverse effects of the AI regimen are presented in This study was approved by the Ethics Committee of Bach
Table 2. Before treatment, the patient’s blood cell count, liver Mai Hospital (approval no: 4460/BM-HĐĐĐ). Written
enzyme levels, and glomerular filtration rate were within informed consent was obtained from the patient before
normal limits. During treatment, the patient tolerated the her participation.
drug well and experienced no adverse effects, such as anemia,
nausea, hair loss, diarrhea, heart failure, or hypersensitivity Consent for publication
reactions. The patient received chemotherapy until the
disease progressed, and metastasis led to the emergence of Informed consent was obtained from the patient to publish
new brain lesions. Unfortunately, the patient and her family her data.
chose to discontinue treatment immediately afterward. The Availability of data
disease progressed after only three cycles and accurately
reflects the malignant and frequently recurring nature of The original data of the study are included in the article.
this tumor. Further inquiries can be directed to the author.

Volume 2 Issue 4 (2024) 4 doi: 10.36922/arnm.3462