Abstract | PURPOSE: PATIENTS AND METHODS: Patients (N = 182) were enrolled onto study between August 1989 and December 1992. After initial surgery, patients with stage I-unfavorable histology (UH; n = 43), stage II (n = 7), stage III (n = 83), and stage IV (n = 40) hepatoblastoma were randomized to receive regimen A (n = 92) or regimen B (n = 81). Patients with stage I-favorable histology (FH; n = 9) were treated with four cycles of doxorubicin alone. RESULTS: There were no events among patients with stage I-FH disease. Five-year event-free survival (EFS) estimates were 57% (SD = 5%) and 69% (SD = 5%) for patients on regimens A and B, respectively (P =.09) with a relative risk of 1.54 (95% confidence interval, 0.93 to 2.5) for regimen A versus B. Toxicities were more frequent on regimen B. Patients with stage I-UH, stage II, stage III, or stage IV disease had 5-year EFS estimates of 91% (SD = 4%), 100%, 64% (SD = 5%), and 25% (SD = 7%), respectively. Outcome was similar for either regimen within disease stages. At postinduction surgery I, patients with stage III or IV disease who were found to be tumor-free had no events; those who had complete resections achieved a 5-year EFS of 83% (SD = 6%); other patients with stage III or IV disease had worse outcome. CONCLUSION: Treatment outcome was not significantly different between regimen A and regimen B. Excellent outcome was achieved for patients with stage I-UH and stage II hepatoblastoma and for subsets of patients with stage III disease. New treatment strategies are needed for the majority of patients with advanced-stage hepatoblastoma.
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Authors | J A Ortega, E C Douglass, J H Feusner, M Reynolds, J J Quinn, M J Finegold, J E Haas, D R King, W Liu-Mares, M G Sensel, M D Krailo |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 18
Issue 14
Pg. 2665-75
(Jul 2000)
ISSN: 0732-183X [Print] United States |
PMID | 10894865
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antibiotics, Antineoplastic
- Vincristine
- Doxorubicin
- Cisplatin
- Fluorouracil
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Topics |
- Antibiotics, Antineoplastic
(therapeutic use)
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Child
- Child, Preschool
- Cisplatin
(administration & dosage)
- Combined Modality Therapy
- Doxorubicin
(administration & dosage, therapeutic use)
- Female
- Fluorouracil
(administration & dosage)
- Hepatoblastoma
(drug therapy, pathology, surgery)
- Humans
- Infant
- Liver Neoplasms
(drug therapy, pathology, surgery)
- Male
- Neoplasm Staging
- Proportional Hazards Models
- Survival Analysis
- Treatment Outcome
- Vincristine
(administration & dosage)
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