Effectiveness and toxicity of cisplatin and doxorubicin (PLADO) in childhood hepatoblastoma and hepatocellular carcinoma: A siop pilot study

Abstract

Sixteen children, aged 16 days to 13 years with hepatoblastoma (HB) (13 patients) or hepatocellular carcinoma (HCC) (3 patients), were given a total of 89 courses of cisplatin and doxorubicin (PLADO) as IV continuous infusion. All tumors were confined to the liver except for 1 hepatoblastoma patient with pulmonary metastases at presentation. Tumor response to PLADO was evaluable in 10 children (8 HB, 2 HCC) treated with preoperative chemotherapy and in another 2 HB patients treated when they developed pulmonary metastases after initial treatment with surgery alone. There were 2 complete responses (2 HB with pulmonary recurrences), 7 very good partial responses (6 HB and 1 HCC), 2 partial responses (1 HB, 1 HCC), and 1 stable disease (HB). The last patient underwent orthotopic liver transplantation whereas all the other patients had their tumor completely excised at delayed surgery. Documented toxicity was BM depression (16 patients), infection (11), vomiting (11), mucositis (3), hearing loss (1), and cardiotoxicity (1). These data indicate that PLADO in continuous infusion is effective in the treatment of malignant epithelial liver tumors with acceptable toxicity.

Treatment of Unresectable Hepatoblastoma with Liver Transplantation in the Pediatric Population

“…It has also been observed that patients requiring transplantation tended to be younger than the mean age of presentation (11). Chemotherapy treatments include combinations of ifosfamide, cisplatin, and Adriamycin (IPA), or cisplatin and doxorubicin (PLADO) (12)(13)(14)(15). Carboplatin may be added in cases of poor response to cisplatin and Adriamycin (16).…”

Liver transplantation for malignant liver tumors in children

“…Furthermore, several centers have reported long-term survival of Stage IV patients after chemotherapy and surgical resection. Review of the literature found 10 reports in which the outcomes of 39 patients with stage IV hepatoblastoma were described [34,35,39,41,[43][44][45][46][47][48]. The chemotherapy regimens differed with regard to agents, doses, and schedules and are not directly comparable.…”

Anthracycline antibiotics induce acute renal tubular toxicity in children with cancer

“…Renal function was evaluated in 160 serum and urine samples obtained from 66 children with various tumors ( [8][9][10][11][12][13][14][15] Progressive damage caused by consecutive DNR treatment was examined in 26 patients with acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) (boys:girls=20:6, all Caucasians, mean age: 8.7±4.5 years, age range: 2-18.0 years, median:7.0 years). Children with standard-risk (SR) ALL and NHL received 2, children with intermediate-(IR) and high-risk (HR) ALL received 4 courses of DNR, as indicated by the treatment protocol.…”