The Effects of Ifosfamide, Carboplatin, and Etoposide in Children with Recurrent/Refractory Solid Tumors

Choe, Gil Soon; Kim, Geong Young; Kim, Ki Joong; Lee, Hahng

Abstract

PURPOSE: The purpose of this study was to evaluate the effects of ifosfamide, carboplatin, etoposide (ICE) regimen in children with recurrent/refractory solid tumors.
METHODS
The medical records of 7 patients diagnosed with recurrent/refractory solid tumors, including osteosarcoma in 2 patients, rhabdomyosarcoma in 2, neuroblastoma in 2 and medulloblastoma in one, and followed at Hanyang University Hospital from January, 1995 until May, 2001, were reviewed. The hematological toxicities above grade III, non-hematological toxicities above grade II, and response rate [complete response (CR) partial response (PR)] after several courses of ifosfamide 1,800 mg/m2/day (day 0 through 4 each cycle), carboplatin 400 mg/m2/day (day 0, 1), etoposide 100 mg/m2/day (day 0 through 4 each cycle) were evaluated.
RESULTS
The incidences of hematological toxicities above grade III and non-hematological toxicities above grade II were 89% and 18%, respectively over the total 56 courses of ICE plus granulocyte colony-stimulating factor (G-CSF: 5.0mug/kg/day). Median time from the start of ICE chemotherapy to absolute neutrophil count (ANC) > or =1,000/mm3 for all patients during the total courses was 15 days. Seven patients evaluated for response to ICE. The overall response rate (CR PR) in this study was 57%. The CR rate for all diagnostic categories was 43%.
CONCLUSION
Our study indicates that myelosuppression was the major toxicity of ICE chemotherapy and non-hematological toxicity was 20% of hematological toxicity except nausea and vomiting. The combination of ICE chemotherapy was associated with a high CR rate (43%) in children with recurrent/refractory solid tumors.