DOI QR코드

DOI QR Code

Replacing Actinomycin-D with Carboplatin for Newly Diagnosed Rhabdomyosarcoma

  • Sezgin, Gulay (Division of Pediatric Oncology and BMT Unit, Cukurova University Medical School) ;
  • Acipayam, Can (Division of Pediatric Oncology and BMT Unit, Cukurova University Medical School) ;
  • Bayram, Ibrahim (Division of Pediatric Oncology and BMT Unit, Cukurova University Medical School) ;
  • Ozkan, Ayse (Division of Pediatric Oncology and BMT Unit, Cukurova University Medical School) ;
  • Kupeli, Serhan (Division of Pediatric Oncology and BMT Unit, Cukurova University Medical School) ;
  • Tanyeli, Atila (Division of Pediatric Oncology and BMT Unit, Cukurova University Medical School)
  • Published : 2015.04.29

Abstract

Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric age group. All patients with RMS regardless of their initial stage or group receive combination chemotherapy as 'standard therapy' consisting of vincristine, actinomycin-D and cyclophosphamide. Actinomycin-D was not readily available in Turkey at one time. Carboplatin was used instead in order to prevent delays in treatment. The aim of this report is to present the results of patients with rhabdomyosarcoma receiving carboplatin or actinomycin-D therapy. Materials and Methods: Twenty four patients with rhabdomyosarcoma treated between December 2000 and June 2011 were included in this retrospective study. The patients were treated according to International Rhabdomyosarcoma Study Group guidelines. Eleven patients were treated with actinomycin-D and 13 with carboplatin ($250mg/m^2/dose$ for 2 days). The two groups were then compared in terms of 2- and 5-year overall survival (OS) and hematological and non-hematological toxicities. Results: Age, sex, stage and the mean duration of follow-up were similar in both groups (p>0.05). Two- and five-year OS levels were 68.2% in the carboplatin group and 78.0% and 40.0%, respectively, in the actinomycin-D group. There was no statistical difference in the number of febrile episodes (p=0.86) and no other hematological and non-hematological adverse effects were recorded in both groups. Conclusions: The findings show that carboplatin can be used as an alternative drug in the primary treatment of rhabdomyosarcoma in the event that actinomycin-D is unavailable or not tolerated.

Keywords

References

  1. Alberts DS, Dorr RT (1998). New perspectives on an old friend:Optimizing carboplatin for the treatment of solid tumors. Oncologist, 3, 15-34.
  2. Carli M, Perilongo G, Cordero di Montezemolo L, et al (1987). Phase II trial of cisplatin and etoposide in children with advanced soft tissue sarcoma: a report from the Italian Cooperative Rhabdomyosarcoma Group. Cancer Treat Rep, 71, 525-7.
  3. Castleberry RP, Cantor AB, Green AA, et al (1994). Phase II investigational window using carboplatin, iproplatin, ifosfamide, and epirubicin in children with untreated disseminated neuroblastoma: A pediatric oncology group study. J Clin Oncol, 12, 1616-20.
  4. Chisholm JC, Machin D, McDowell H, et al (2007). Efficacy of carboplatin given in a phase II window study to children and adolescents with newly diagnosed metastatic soft tissue sarcoma. Eur J Cancer, 43, 2537-44. https://doi.org/10.1016/j.ejca.2007.08.024
  5. Crist W, Gehan EA, Ragab AH, et al (1995). The third intergroup rhabdomyosarcoma study. J Clin Oncol, 13, 610-30.
  6. Crist WM, Anderson JR, Meza JL, et al (2001). Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. J Clin Oncol, 19, 3091-102.
  7. Dharmarajan KV, Wexler LH, Wolden SL (2013). Concurrent radiation with irinotecan and carboplatin in intermediateand high-risk rhabdomyosarcoma: A report on toxicity and efficacy from a prospective pilot phase II study. Pediatr Blood Cancer, 60, 242-7. https://doi.org/10.1002/pbc.24205
  8. Estlin EJ, Veal GJ (2003). Clinical and cellular pharmacology in relation to solid tumours of childhood. Cancer Treat Rev, 29, 253-73. https://doi.org/10.1016/S0305-7372(02)00109-3
  9. Frascella E, Pritchard-Jones K, Modak S, et al (1996). Response of previously untreated metastatic rhabdomyosarcoma to combination chemotherapy with carboplatin, epirubicin and vincristine. Eur J Cancer, 32, 821-5. https://doi.org/10.1016/0959-8049(95)00665-6
  10. Gaynon PS, Lawrence J, Ettinger MD, et al (1990). Carboplatin in childhood brain tumors. Cancer, 66, 2465-9. https://doi.org/10.1002/1097-0142(19901215)66:12<2465::AID-CNCR2820661204>3.0.CO;2-N
  11. Ge X, Huang DS, Shi JT et al (2013). Multidisciplinary collaborative therapy for 30 children with orbital rhabdomyosarcoma. Asian Pac J Cancer Prev, 14, 4641-6 https://doi.org/10.7314/APJCP.2013.14.8.4641
  12. Gosiengfiao Y, Reichek J, Walterhouse D (2012). What is New in Rhabdomyosarcoma Management in Children?. Pediatr Drugs, 14, 389-400.
  13. Kang MH, Smith MA, Morton CL, et al (2011). National Cancer Institute pediatric preclinical testing program: model description for in vitro cytotoxicity testing. Pediatr Blood Cancer, 56, 239-49. https://doi.org/10.1002/pbc.22801
  14. Lanzkowsky P (2011). Rhabdomyosarcoma and other soft-tissue sarcomas. in: lanzkowsky p, editor. manual of pediatric hematology and oncology. San Diego: Elsevier, Inc.; pp. 715-738.
  15. Maurer HM, Gehan EA, Beltangady M, et al (1993).The Intergroup Rhabdomyosarcoma Study-II. Cancer, 71, 1904-22. https://doi.org/10.1002/1097-0142(19930301)71:5<1904::AID-CNCR2820710530>3.0.CO;2-X
  16. Missaoui N, Landolsi H, Jaidene L et al (2010). Pediatric rhabdomyosarcoma in Tunisia. Asian Pacific J Cancer Prev, 11, 1325-27.
  17. Oberlin O, Rey A, de Toledo JS, et al (2012). Randomized comparison of intensified six-drug versus standard three-drug chemotherapy for high-risk nonmetastatic rhabdomyosarcoma and other chemotherapy-sensitive childhood soft tissue sarcomas: long-term results from the international society of pediatric oncology MMT95 Study. J Clin Oncol, 30, 2457-65. https://doi.org/10.1200/JCO.2011.40.3287
  18. Stevens MCG, Rey A, Bouvet N, et al (2005). treatment of nonmetastatic rhabdomyosarcoma in childhood and adolescence: third study of the international society of paediatric oncology-SIOP malignant mesenchymal tumor 89. J Clin Oncol, 23, 2618-28.
  19. Van Winkle P, Angiolillo A, Krailo M, et al (2005). Ifosfamide, carboplatin, and etoposide (ICE) reinduction chemotherapy in a large cohort of children and adolescents with recurrent/refractory sarcoma: the Children's Cancer Group (CCG) experience. Pediatr Blood Cancer, 44, 338-47. https://doi.org/10.1002/pbc.20227
  20. Wexler LH, Meyer WH, Helman LJ (2011). Rhabdomyosarcoma. In : Pizzo PA, Poplack DG, editors. Principles and practice of pediatric oncology. philadelphia: Lippincot Williams and Wilkins/Wolters Kluwer. ; pp. 923-953.

Cited by

  1. Treatment Outcome and Predictors of Survival in Thai Adult Rhabdomyosarcoma Cases vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1449
  2. Biological indicators of chemoresistance: an ex vivo analysis of γH2AX and p53 expression in feline injection-site sarcomas vol.18, pp.1, 2018, https://doi.org/10.1186/s12935-018-0690-0