We prospectively evaluated tumour response and renal function in 12 newly diagnosed children with high-risk Wilms tumour receiving ifosfamide, carboplatin and etoposide (ICE) chemotherapy. Two cycles of ICE were followed by 5 weeks of vincristine, dactinomycin and doxorubicin (Adriamycin) (VDA), and nephrectomy, radiotherapy, additional VDA, and a third ICE cycle. Carboplatin dosage was based on glomerular filtration rate (GFR) to achieve targeted systemic exposure (6 mg/ml min). Mean GFR (measured by technetium 99 m-DTPA clearance) declined by 7% after 2 cycles of ICE and by 38% after nephrectomy; the mean carboplatin dose was reduced 32% after nephrectomy. Mean GFR remained stable after the third ICE cycle. Although urinary β2-microglobulin excretion increased during therapy, no patient had clinically significant renal tubular dysfunction at the end of treatment. Treatment with ICE, nephrectomy and radiotherapy significantly reduces GFR, largely as the result of nephrectomy. Adjustment of carboplatin dosage on the basis of GFR and careful monitoring of renal function may alleviate nephrotoxicity.
|Number of pages||8|
|Journal||European Journal of Cancer|
|State||Published - Jan 2009|
Bibliographical noteFunding Information:
Supported in part by United States Public Health Service Cancer Center Support Grant CA21765, Program Project Grant CA23099, and by the American Lebanese Syrian Associated Charities (ALSAC). Presented in part at the Thirty-fifth Annual Meeting of the American Society of Clinical Oncology, May 15–18, 1999.
- Glomerular filtration rate
- Kidney neoplasms
- Renal function
ASJC Scopus subject areas
- Cancer Research