Therapy details
Chemotherapy and local control therapies are described in Table 2. Nine patients (64%) completed the intended 8 cycles of VDC-ICE chemotherapy. In the five remaining patients (36%), the planned treatment regimen was discontinued for disease progression. Three patients (21%) received additional chemotherapy concurrently with VDC-ICE. This additional chemotherapy for all three patients consisted of cycles of vincristine and irinotecan (VI) intermixed with VDC-ICE, as data emerged that the addition of VI improved outcome for patients with DAWT.
For the 9 patients who completed treatment, the median cumulative dose received was 6000 mg/m2 of cyclophosphamide (range=4800-8400), 24 g/m2 of ifosfamide (range=21-24), and 270 mg/m2 of doxorubicin (range=135-450). All patients received dexrazoxane as cardio-protection with doxorubicin, and all received growth factor after each chemotherapy cycle.
Local control therapy consisted of surgery and/or radiation. Nine (64%) patients received radiation to the primary site of disease, and 3 (21%) received additional radiation to metastatic sites. Most (n=7/9; 78%) patients received radiation therapy concurrent with chemotherapy. Ten patients underwent some form of surgical resection, which was performed upfront, prior to chemotherapy initiation, in 6 patients. Complete surgical resection was achieved in 70% (n=7/10) of all patients who underwent resection and in 78% (n=7/9) of patients who received radiation therapy.