Treatment of advanced malignant hemangiopericytoma with combination adriamycin and DTIC: a report of four cases.

One patient with a large inoperable malignant hemangiopericytoma and three patients with local recurrence and/or metastases were treated with combination adriamycin, 50 mg/m2, and DTIC, 600-700 mg/m2, intravenously every 4 weeks. Two achieved palliation, one with measureable shrinkage of tumor, and the other with loss of incapacitating lower limb edema secondary to vascular and lymphatic obstruction. The third patient objectively had a less than partial response. The fourth patient did not respond to adriamycin and DTIC or to a subsequent trial of cis-platinum, 60 mg/m2, intravenously every 3 weeks. However, radiotherapy produced an objective response at the site of the local recurrence and relief of painful bone metastases. Two patients died of progressive disease; the third patient has stable disease and is continuing chemotherapy; and the fourth patient died, probably from adriamycin-induced cardiac failure in the presence of rapidly advancing intraabdominal metastases. The combination of adriamycin and DTIC is active in malignant hemangiopericytoma, and palliation of advanced disease can be achieved. However, prolonged survival is uncommon in the presence of a large tumor burden.