Five-day courses of irinotecan as palliative therapy for patients with neuroblastoma Journal Article
| Authors: | Kushner, B. H.; Kramer, K.; Modak, S.; Cheung, N. K. V. |
| Article Title: | Five-day courses of irinotecan as palliative therapy for patients with neuroblastoma |
| Abstract: | BACKGROUND. The authors describe a large experience using short courses of irinotecan for palliative therapy in patients with neuroblastoma (NB). Quality of life was a major issue in choosing this regimen for patients whose disease was resistant to standard anti-NB therapies. METHODS. A retrospective review was conducted of all patients who were followed by the Department of Pediatrics at Memorial Sloan-Kettering Cancer Center and treated for resistant NB with irinotecan at 50 mg/m2 per day for 5 days as a 1-hour intravenous infusion. Treatment was outpatient, and there was a minimum 2-week rest period between courses. Granulocyte colony-stimulating factor was used to keep the absolute neutrophil count > 500-1000/mL. RESULTS. Forty-four patients had been treated aggressively and/or extensively before they received one or more five-day courses of irinotecan. Emetogenic, diarrheal, and myelosuppressive effects were readily managed. Hospitalizations were limited to three patients with bacteremia. Twenty-three patients had a change in therapy, although they did not have progressive disease (PD) after receiving 1 (n = 10), 2 (n = 3), 3 (n = 1), 4 (n = 6), 7 (n = 1 patient), 22 (n = 1 patient), or 24 (n = 1) courses. The most common reasons for changing treatment were to intensify retrieval therapy or to pursue immunotherapy. Of those 23 patients, 15 patients had stable disease, 7 were not evaluable for response because of concurrent radiotherapy, and 1 patient had a major response. Twenty-one patients had PD after 1 (n = 3, 2 (n = 9), 4 (n = 2), 5 (n = 1), 6 (n = 3), 7 (n = 1), 9 (n = 1), and 11 (n = 1) courses. CONCLUSIONS. In heavily treated patients, the regimen studied was well tolerated, allowed patients to continue most normal life activities, and produced anti-NB effects. Its modest toxicity supported use with other antitumor agents. © 2005 American Cancer Society. |
| Keywords: | adolescent; adult; child; clinical article; controlled study; treatment outcome; child, preschool; retrospective studies; review; salvage therapy; cisplatin; diarrhea; liver dysfunction; cancer radiotherapy; cancer palliative therapy; palliative care; cancer immunotherapy; quality of life; nephrotoxicity; bone marrow suppression; etoposide; leukopenia; nausea; thrombocytopenia; antineoplastic agents, phytogenic; camptothecin; cyclophosphamide; vincristine; irinotecan; chemotherapy induced emesis; gastrointestinal toxicity; hospitalization; neutrophil; neuroblastoma; cardiotoxicity; drug response; drug infusion; daily life activity; loperamide; bacteremia; leukocyte count; erythrocyte transfusion; bacterial infection; alopecia; infusions, intravenous; granulocyte colony stimulating factor; outpatient care; atropine; thrombocyte transfusion; pediatrics; novel therapeutics; nervous system neoplasms; short course therapy; diphenoxylate; antitumor cytotoxicity |
| Journal Title: | Cancer |
| Volume: | 103 |
| Issue: | 4 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2005-02-15 |
| Start Page: | 858 |
| End Page: | 862 |
| Language: | English |
| DOI: | 10.1002/cncr.20846 |
| PUBMED: | 15637685 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 14" - "Export Date: 24 October 2012" - "CODEN: CANCA" - "Source: Scopus" |
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