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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.178    [Accepted]
Vincristine, Irinotecan, and Temozolomide as a Salvage Regimen for Relapsed or Refractory Sarcoma in Children and Young Adults
Hee Young Ju1,2, Meerim Park2, Jun Ah Lee2, Hyeon Jin Park2, Seog Yun Park3, June Hyuk Kim4, Hyun Guy Kang4, Hee Chul Yang5, Byung-Kiu Park2
1Department of Pediatrics, Samsung Medical Center, Seoul, Korea
2Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
3Department of Pathology, National Cancer Center, Goyang, Korea
4Orthopaedic Oncology Clinic, National Cancer Center, Goyang, Korea
5Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
Correspondence  Byung-Kiu Park ,Tel: 82-31-920-1240, Fax: 82-31-920-1244, Email: bkpark@ncc.re.kr
Received: February 3, 2021;  Accepted: June 11, 2021.  Published online: June 14, 2021.
ABSTRACT
Purpose
No standard salvage regimen is available for relapsed or refractory sarcoma. We investigated the efficacy and toxicity of the vincristine, irinotecan, and temozolomide combination (VIT) for relapsed or refractory sarcomas of variable histology in children and young adults.
Materials and Methods
We retrospectively reviewed data from the relapsed or refractory sarcoma patients who were treated with VIT. The VIT protocol was given every 3 weeks as follows: vincristine, 1.5mg/m2 intravenously on day 1, irinotecan, 50mg/m2/day intravenously on days 1-5, and temozolomide, 100mg/m2/day orally on days 1-5.
Results
A total of 26 patients (12 males) with various sarcoma histology were included in the study. Most common diagnosis was rhabdomyosarcoma (n=8) followed by osteosarcoma (n=7). Median age at the start of VIT was 18.5 years (range, 2.0 to 39.9). VIT was delivered as 2nd to 7th line of treatment, with 4th line most common (9/26, 34.6%). Median number of VIT courses given was 3 (range, 1 to 18). Of the 25 evaluable patients, there was two partial response (PR) and 11 stable disease (SD) with an overall control rate (CR + PR + SD) of 52%. PR was seen in one (50%) of the 2 evaluable patients with Ewing sarcoma and one (14.3%) of the seven patients with osteosarcoma. Overall survival and progression-free survival rates were 79.3% and 33.9% at 1 year, and 45.5% and 25.4% at two years, respectively. There was no treatment-related mortality.
Conclusion
The VIT regimen was effective and relatively safe in our cohort of sarcoma patients.
Key words: Salvage therapy, Sarcoma, Vincristine, Temozolomide, Irinotecan
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