High-dose cisplatin and etoposide in advanced malignancies of childhood.
Thirty-two children with poor-prognosis solid tumors were treated with a combination of high-dose cisplatin (CDDP) (200 mg/m2 over 5 days) and VP16. In the 30 children evaluable for antitumor effect, there were 7 complete, 12 partial, and 3 minor tumor responses. Wilms' tumor and rhabdomyosarcoma responded best. There were no therapy-related deaths. Severe neutropenia (PMN less than 500/mmc) developed after 29 out of the 45 evaluable courses and lasted a median of 8 days; during periods of neutropenia 8 episodes of fever occurred, 1 of which was caused by streptococcal sepsis. Platelet levels were depressed to less than 50,000/mmc after 17/45 cycles and this thrombocytopenia lasted a median of 8 days. No neurological toxicity occurred. One case developed acute renal failure. A hearing deficit for high frequencies was documented in 14/22 patients evaluated after the first cycle and in all cases after the subsequent cycles; the deficits correlated with the total dose of CDDP administered. High-dose cisplatin and VP16 is an effective association in children with advanced cancer, but cumulative dosage is limited by ototoxicity.
Perin
G
G
Department of Hematology-Oncology, Giannina Gaslini Children's Hospital, Genova, Italy.
Dallorso
S
S
Stura
M
M
Moroni
C
C
Rogers
D
D
Dini
G
G
De Bernardi
B
B
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000139:chemically induced; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004341:Drug Evaluation; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014839:Vomiting / Q000139:chemically induced
D005047:Etoposide; D002945:Cisplatin