Abstract
Several combination therapies have been employed as palliative chemotherapies for refractory solid tumors. Although irinotecan (IRT) plus temozolomide (TMZ) (IT therapy) has been demonstrated to be tolerable and active in children with relapsed solid tumors, this combination chemotherapy has not been reported in Japanese patients. We retrospectively reviewed the toxicity and efficacy of IT therapy in eight patients with refractory solid tumors. Three patients had Ewing sarcoma/PNET, and five had undifferentiated sarcoma, hepatoblastoma, infantile fibrosarcoma, neuroblastoma, or Wilms tumor. All the patients received various therapies for their disease, including chemotherapy, radiotherapy, tumor resection, autologous peripheral blood stem cell transplantation or cord blood transplantation. All eight patients received a total of 27 courses, with a median of three courses per patient. Seven patients received oral TMZ (150 mg/m2/day) plus intravenous IRT (50 mg/m2/day) on days 1–5, and one received oral TMZ (100 mg/m2/day) on days 1–5 plus IRT (20 mg/m2/day) on days 1–5 and 8–12. We observed partial responses in three patients, stable disease in four patients, and progressive disease in one patient, with a median of three courses of IT therapy. Four patients died of progressive disease, one patient is currently disease-free, and three survived with stable disease. Toxicities included grade 3 diarrhea (three courses, 11.1%), grades 3–4 neutropenia (nine courses, 33.3%), and grades 3–4 thrombocytopenia (two courses, 7.4%). IT therapy was tolerable and effective for Japanese children with refractory solid tumors and who had completed other various chemotherapies.
