Klin Onkol 1999; 12(5): 165-168.
Summary: Background:Topotecan, a water-soluble semisynthetic analogue of camptotecin, is the first topoisomerase inhibitor. In combination with cyclophospharnide, tis under evaluation in pediatric patients with refractory or relapsed malignancies. Design and Subjects: In our study eleven patients with solid tumors (3 patients with rhabdomyosarcoma, 2 patients with undifferentiated sarcoma, 1 patient with liver embryonal sarcoma and 1 patient with malignant schwannom, 3 patients with neuroblastoma and one patient with Ewing sarcoma, were given topotecan (0,75 mg/m2/day) and cyclophospharnide (250 mg/m2/day) or etoposide (100 mg/m2/day) for five consecutive days. Methods and Results: Five patients started chemotherapy in complete remission, 3 in partial remission (1 of them in very good partial remission) and 3 in disease progression. Five patients, treated in complete remission remain in complete remission. The others, treated in very good partial remission, partial remission or disease progression progressed and died in a short period (except 2 disease progression survivals). Severe hematological complications, nausea and vomiting, were managed by supportive care. With an exception of one pretreated child, there was no delay in the chemotherapy. Conclusions: Our results indicate lhal topotecan may be a successful drug in pediatric malignancies. Further prospective trials using topotecan during the upfront phase are required.
