Tolerability, complications, and toxicity
The primary aim of this study was to describe the complications and toxicity associated with this treatment plan. Data were abstracted from the record, described categorically, and graded using the common terminology criteria for adverse events version 5 (CTCAE v5.0). Information abstracted included: unplanned hospitalizations and admissions to the intensive care unit (ICU), unplanned ambulatory clinic or emergency department (ED) visits (not for scheduled chemotherapy, routine examinations, or restaging); significant infections, such as central line-associated bloodstream infection, and treatment delays. A treatment delay was defined as an interval of greater than four weeks between chemotherapy cycles (one week longer than expected) or greater than five weeks if surgery was performed (two weeks longer than expected without surgery). Organ toxicity (except for hematopoietic and transient minor elevation of liver function tests), admissions for fever and neutropenia, uncontrolled nausea, and vomiting were recorded and graded. Long-term toxicities (organ toxicities grades 3 and 4) and impact on growth were noted in follow-up until the last contact at the time of record abstraction.