Vincristine and irinotecan in children with relapsed hepatoblastoma: a single-institution experience

Pediatr Hematol Oncol. 2015 Feb;32(1):18-25. doi: 10.3109/08880018.2014.909913. Epub 2014 May 22.

Abstract

Purpose: This study was to determine the efficacy of vincristine and irinotecan in children with relapsed hepatoblastoma (HB).

Methods: A total of 10 patients with relapsed HB were enrolled. Three patients were excluded. Patients received irinotecan 50 mg/m(2)/day, day 1-5 and vincristine 1.5 mg/m(2)/day, day 1, repeated every 3 weeks. The maximum cycles were eight. Reevaluation of tumor was performed every two cycles. The primary outcome was the rate of complete resection. Secondary outcomes were event-free survival (EFS) and overall survival (OS).

Results: Of the seven patients assessable for response, one patient with normal AFP level showed a progressive disease and withdrew. He finally died 6 months later. Four had PR, all of them underwent a second surgery and achieved complete resection. Two patients had SD, one patient relapsed 6 months after orthotopic liver transplantation and died, the other one undergoing surgery had micro margin positive, he relapsed again but alive. The rate of complete resection was 71.4% (including orthotopic liver transplantation). The 2-year EFS and OS for the whole group were 57.1% (95% CI, 12.7% to 34.2%) and 71.4% (95% CI, 16.39% to 37.4%), respectively.

Conclusions: The combination of irinotecan and vincristine has a significant antitumor activity and acceptable toxicity in children with relapsed HB.

Keywords: children; hepatoblastoma; irinotecan; relapsed hepatoblastoma.

Publication types

  • Clinical Trial

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Child, Preschool
  • Disease-Free Survival
  • Hepatoblastoma* / mortality
  • Hepatoblastoma* / therapy
  • Humans
  • Infant
  • Irinotecan
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / therapy
  • Liver Transplantation
  • Neoplasm Recurrence, Local* / mortality
  • Neoplasm Recurrence, Local* / therapy
  • Survival Rate
  • Time Factors
  • Vincristine / administration & dosage

Substances

  • Vincristine
  • Irinotecan
  • Camptothecin