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Titolo:
Very intensive, short-term chemotherapy for children and adolescents with metastatic sarcomas
Autore:
Felgenhauer, J; Hawkins, D; Pendergrass, T; Lindsley, K; Conrad, KU; Miser, JS;
Indirizzi:
Deaconess Med Ctr, Spokane, WA USA Deaconess Med Ctr Spokane WA USADeaconess Med Ctr, Spokane, WA USA Univ Washington, Dept Pediat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 , Dept Pediat, Seattle, WA 98195 USA Univ Washington, Dept Radiat Oncol, Seattle, WA 98195 USA Univ WashingtonSeattle WA USA 98195 Radiat Oncol, Seattle, WA 98195 USA Univ Washington, Dept Orthopaed Surg, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 rthopaed Surg, Seattle, WA 98195 USA City Hope Natl Med Ctr, Dept Pediat, Duarte, CA 91010 USA City Hope Natl Med Ctr Duarte CA USA 91010 t Pediat, Duarte, CA 91010 USA
Titolo Testata:
MEDICAL AND PEDIATRIC ONCOLOGY
fascicolo: 1, volume: 34, anno: 2000,
pagine: 29 - 38
SICI:
0098-1532(200001)34:1<29:VISCFC>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOCALIZED EWINGS-SARCOMA; INTERGROUP RHABDOMYOSARCOMA; DOSE INTENSITY; YOUNG-ADULTS; MESNA UROPROTECTION; MULTIMODAL THERAPY; PEDIATRIC ONCOLOGY; PROGNOSTIC FACTOR; SOFT-TISSUE; STAGE-II;
Keywords:
sarcoma; metastatic disease; pediatrics; chemotherapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Hawkins, D Childrens Hosp & Reg Med Ctr MS, CH29,4800 Sand Point Way, Seattle, WA 98105 USA Childrens Hosp & Reg Med Ctr MS CH29,4800 Sand Point Way Seattle WA USA 98105
Citazione:
J. Felgenhauer et al., "Very intensive, short-term chemotherapy for children and adolescents with metastatic sarcomas", MED PED ONC, 34(1), 2000, pp. 29-38

Abstract

Background. To improve the prognosis for pediatric patients with metastatic sarcomas, including the Ewing sarcoma family of tumors (ESFT), rhabdomyosarcoma (RMS), and undifferentiated sarcoma (UDS), we tested the feasibilityof a brief, intensive regimen of chemotherapy that maximizes dose intensity. Procedure. Twenty-four children and adolescents with metastatic sarcomasreceived VAC[ME chemotherapy, consisting of eight courses of vincristine 2mg/m(2) on day 0; doxorubicin 20 mg/m(2)/day on days 0-3; cyclophosphamide360 mg/m(2)/day on days 0-4; ifosfamide 1,800 mg/m(2)/day on days 0-4; mesna 2,400 mg/m(2)/day; and etoposide 100 mg/m(2)/day on days 0-4. Doxorubicin was omitted in courses 7 and 8. Granulocyte colony-stimulating factor (GCSF) was used routinely following each course of therapy. Courses of therapywere repeated every 21 days or as soon as hematopoietic recovery and resolution of nonhematopoietic toxicities permitted. Surgical resection followedcourse 6, and radiotherapy followed the completion of all therapy. Results. Thirteen patients achieved a complete response (CRI with chemotherapy alone, and seven more achieved a CR following surgical resection after course 6 (overall CR rate 83%). There was one toxic death. Thirteen patients developed progressive disease, with 2- and 4-year event-free survivals (95% confidence interval) of 50% (30-70%) and 45% (25-65%), respectively. Myelosuppression was severe and cumulative, leading to dose reductions and chemotherapy interval delays. Mucositis was the most common nonhematopoietic toxicity. Conclusions. VACIME chemotherapy was a feasible dose-intensive regimen for pediatric patients with metastatic sarcomas. Cumulative hematopoietic toxicity and severe mucositis limited the delivery of chemotherapy as prescribed. The CR and 2-year event-free survival rates were superior to those of most previously reported regimens. (C) 2000 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 12:08:01