Purpose: The use of neoadjuvant chemotherapy has improved the survival of patients with hepatoblastoma (HB). However, an increased number of treatment complications and toxic deaths, particularly from heart failure, have been observed with doxorubicin treatment. We have applied cisplatin as a single agent to treat children with high-risk HB to improve event-free survival (EFS).
Methods: Between 2007 and 2009, 14 patients with untreated high-risk HB were enrolled in this study. All the patients received a single-agent treatment of cisplatin. The initial cisplatin cycle was administered in a continuous intravenous 24-hour infusion of 80 mg/m2/24 h. The primary outcome was the rate of complete resection. Secondary outcomes were EFS and overall survival (OS).
Results: Eleven patients (78.6%) had an overall partial response. Two patients (14.3%) had stable disease. One patient experienced (7.1%) progression. Of the 4 patients who presented with lung metastases initially, 1 patient achieved complete response, 2 patients achieved partial response, and 1 patient experienced progression during preoperative chemotherapy. The complete resection rate was 78.6% (95% CI, 49%-95%). The Kaplan-Meier estimates of 2-year EFS and OS for the whole group were 64.3% (95% CI, 35%-87%) and 85.7% (95% CI, 57%-98%), respectively. The 2-year EFS and OS rates of patients who achieved complete resection were 81.8% (95% CI, 48%-98%) and 100% (95% CI, 62%-100%), respectively.
Conclusions: The single-agent cisplatin had less toxicity than cisplatin plus doxorubicin and achieved an equal rate of complete resection in high-risk HB compared with conventional multiagent chemotherapy.
Departments of *Pediatric Hematology and Oncology
†Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, Jilin, China
The authors declare no conflict of interest.
Reprints: Jian Chang, MD, Department of Pediatric Hematology and Oncology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun 130021, Jilin, China (e-mail: email@example.com).
Received January 3, 2013
Accepted October 16, 2013