Renal function after ifosfamide, carboplatin and etoposide (ICE) chemotherapy, nephrectomy and radiotherapy in children with wilms tumour

Najat C. Daw; David Gregornik; John Rodman; Neyssa Marina; Jianrong Wu; Larry E. Kun; Jesse J. Jenkins; Valerie McPherson; Judith Wilimas; Deborah P. Jones

doi:10.1016/j.ejca.2008.09.017

Renal function after ifosfamide, carboplatin and etoposide (ICE) chemotherapy, nephrectomy and radiotherapy in children with wilms tumour

Najat C. Daw, David Gregornik, John Rodman, Neyssa Marina, Jianrong Wu, Larry E. Kun, Jesse J. Jenkins, Valerie McPherson, Judith Wilimas, Deborah P. Jones

Internal Medicine

Research output: Contribution to journal › Article › peer-review

32 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	99-106
Number of pages	8
Journal	European Journal of Cancer
Volume	45
Issue number	1
DOIs	https://doi.org/10.1016/j.ejca.2008.09.017
State	Published - Jan 2009

Bibliographical note

Funding 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.

Funding

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.

Funders	Funder number
United States Public Health Service Cancer Center Support	CA21765
National Childhood Cancer Registry – National Cancer Institute	P01CA023099
American Lebanese Syrian Associated Charities

Keywords

Carboplatin
Creatinine
Glomerular filtration rate
Ifosfamide
Kidney neoplasms
Nephrectomy
Renal function

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ejca.2008.09.017

Cite this

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title = "Renal function after ifosfamide, carboplatin and etoposide (ICE) chemotherapy, nephrectomy and radiotherapy in children with wilms tumour",

abstract = "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.",

keywords = "Carboplatin, Creatinine, Glomerular filtration rate, Ifosfamide, Kidney neoplasms, Nephrectomy, Renal function",

author = "Daw, {Najat C.} and David Gregornik and John Rodman and Neyssa Marina and Jianrong Wu and Kun, {Larry E.} and Jenkins, {Jesse J.} and Valerie McPherson and Judith Wilimas and Jones, {Deborah P.}",

note = "Funding 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. ",

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AU - Wu, Jianrong

AU - Kun, Larry E.

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AU - Wilimas, Judith

AU - Jones, Deborah P.

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Renal function after ifosfamide, carboplatin and etoposide (ICE) chemotherapy, nephrectomy and radiotherapy in children with wilms tumour

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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