Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: A report from the children's cancer group and the pediatric oncology group

Jorge A. Ortega*, Edwin C. Douglass, James H. Feusner, Marleta Reynolds, John J. Quinn, Milton J. Finegold, Joel E. Haas, Denis R. King, Wen Liu-Mares, Martha G. Sensel, Mark D. Krailo

*Corresponding author for this work

Research output: Contribution to journalArticle

243 Scopus citations

Abstract

Purpose: Previous studies demonstrated that chemotherapy with either cisplatin, vincristine, and fluorouracil (regimen A) or cisplatin and continuous infusion doxorubicin (regimen B) improved survival in children with hepatoblastoma. The current trial is a randomized comparison of these two regimens. Patients and Methods: Patients (N = 182) were enrolled onto study between August 1989 and December 1992. After initial surgery, patients with state I-unfavorable histology (UH; n = 43), state II (n = 7), state III (n = 83), and stage IV (n = 40) hepatoblastoma were randomized to receive regimen A (n = 92) or regimen B (n = 81). Patients with stage I-favorable histology (FH; n = 9) were treated with four cycles of doxorubicin alone. Results: There were no events among patients with state I-FH disease. Five-year event-free survival (EFS) estimates were 57% (SD = 5%) and 69% (SD = 5%) for patients on regimens A and B, respectively (P = .09) with a relative risk of 1.54 (95% confidence interval, 0.93 to 2.5) for regimen A versus B. Toxicities were more frequent on regimen B. Patients with stage I-UH, stage II, stage III, or stage IV disease had 5-year EFS estimates of 91%) SD = 4%), 100%, 64% (SD = 5%), and 25% (SD = 7%), respectively. Outcome was similar for either regimen within disease stages. At postinduction surgery I, patients with stage III or IV disease who were found to be tumor-free had no events; those who had complete resections achieved a 5-year EFS of 83% (SD = 6%); other patients with stage III or IV disease had worse outcome. Conclusion: Treatment outcome was not significantly different between regimen A and regimen B. Excellent outcome was achieved for patients with stage I-UH and stage II hepatoblastoma and for subsets of patients with stage III disease. New treatment strategies are needed for the majority of patients with advanced- state hepatoblastoma. (C) 2000 by American Society of Clinical Oncology.

Original languageEnglish (US)
Pages (from-to)2665-2675
Number of pages11
JournalJournal of Clinical Oncology
Volume18
Issue number14
DOIs
StatePublished - Jul 2000

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: A report from the children's cancer group and the pediatric oncology group'. Together they form a unique fingerprint.

  • Cite this