Therapy details
Chemotherapy and local control therapies are described in Table 2. Nine
patients (64%) completed the intended 8 cycles of VDC-ICE chemotherapy.
In the five remaining patients (36%), the planned treatment regimen was
discontinued for disease progression. Three patients (21%) received
additional chemotherapy concurrently with VDC-ICE. This additional
chemotherapy for all three patients consisted of cycles of vincristine
and irinotecan (VI) intermixed with VDC-ICE, as data emerged that the
addition of VI improved outcome for patients with DAWT.
For the 9 patients who completed treatment, the median cumulative dose
received was 6000 mg/m2 of cyclophosphamide
(range=4800-8400), 24 g/m2 of ifosfamide
(range=21-24), and 270 mg/m2 of doxorubicin
(range=135-450). All patients received dexrazoxane as cardio-protection
with doxorubicin, and all received growth factor after each chemotherapy
cycle.
Local control therapy consisted of surgery and/or radiation. Nine (64%)
patients received radiation to the primary site of disease, and 3 (21%)
received additional radiation to metastatic sites. Most (n=7/9; 78%)
patients received radiation therapy concurrent with chemotherapy. Ten
patients underwent some form of surgical resection, which was performed
upfront, prior to chemotherapy initiation, in 6 patients. Complete
surgical resection was achieved in 70% (n=7/10) of all patients who
underwent resection and in 78% (n=7/9) of patients who received
radiation therapy.