Abstract
Twenty-six children with gross residual (18) or metastatic (8) rhabdomyosarcoma were treated with pulse-VAC (Vincristine weekly × 11 plus actinomycin D and cyclophosphamide simultaneously for 5 days) and radiotherapy. Toxicity during the 12-week induction period included 22/26 patients (85%) with an absolute neutrophil count (ANC) under 500/mm3; 15/26 (58%) received intravenous antibiotics. Three developed Gram-negative sepsis and 2 of them died. In 25 patients followed 12 weeks, there were 4 complete responses (CR) and 5 partial responses (PR), a total of 36%. At 12 weeks 6 patients randomly received intermittent pulse-VAC (Regimen H) and 9 received pulse-VAC alternating with Adriamycin (Reg. I). After this pulse, 7/15 (47%) had a low ANC; none had severe infection and only 3 received antibiotics. Severe toxicity disappeared with subsequent dose reduction. To date, CR rate averages 48%, 36% on Reg. H and 58% on Reg. I; the overall partial response rate is 26%. However 5/7 CR patients on Reg. I had an orbital primary. Despite increased toxicity, these regimens are no better than current IRS schedules for advanced disease. Introducing adriamycin before 12 weeks may deserve trial in attempting to improve the response rate.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Raney, R., Donaldson, M., Maurer, H. et al. 652 ADVANCED CHILDHOOD RHABDOMYOSARCOMA: TOXICITY AND RESPONSE TO INTENSIVE CHEMOTHERAPY. Pediatr Res 12 (Suppl 4), 472 (1978). https://doi.org/10.1203/00006450-197804001-00657
Issue Date:
DOI: https://doi.org/10.1203/00006450-197804001-00657