Cisplatin, vincristine, and fluorouracil therapy for hepatoblastoma: A pediatric oncology group study

Purpose: To estimate the disease-free survival rate in children with grossly resected hepatoblastoma treated with cisplatin, vincristine, and fluorouracil (CDDP/VCR/ FU) and to assess the disease-response rate and disease-free survival (DPS) rate in children with unresectable or metastatic tumors treated with this combination. Patients and Methods: Sixty assessable patients with hepatoblastoma received therapy with five (stage I and II) to seven (stage III and IV) courses of CDDP (90 mg/ m²), day 1, and VCR (1.5 mg/m²), and FU (600 mg/m²), day 3. Results: Nineteen of 21 patients with stage I or II disease survive free of disease (actuarial survival, 90% at 5 years). Twenty-four of 31 patients with stage III disease achieved a complete remission (CR) after chemotherapy and surgical excision; actuarial DPS at 4 years is 67%. Only one of eight patients with stage IV disease achieved a remission and survives. Conclusion: Relatively brief exposure to chemotherapy with CDDP/VCR/FU provided excellent disease control to patients with grossly resected tumors. In patients with initially unresectable disease, this therapy provides a response rate and DPS rate comparable to regimens that contain doxorubicin (DOX).