| Intravenous chemotherapy |
| Carboplatin (C) |
560 mg/M2 in 120 cc/M2 D51/4NS IVSS over 60 min |
Day 0 of each cycle (18.6 mg/kg for patients <36 months of age) |
| Etoposide (E) |
150 mg/M2 in 150 cc/M2 D51/4NS IVSS over 60 min |
Days 0 and 1 of each course (5 mg/kg for patients <36 months of age) |
| Vincristine (V) |
1.5 mg/M2 IVSS over 15 minutes |
Day 0 of each cycle (0.05 mg/kg for patients <36 months of age).
Maximum vincristine dose not to exceed 2 mg |
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| Antiemetic drug |
| Ondansetron |
0.45 mg/kg IVSS (maximum dose 24 mg) prior to therapy |
Days 0 and 1 of each cycle, with Dexamethasone 0.25 mg/kg IVSS prior to therapy days 0 and 1 of each cycle |
| Phenergen |
0.5 mg/kg p.o. h.s. on |
Day 0 and then every 6 h prn with emesis |
| Diphenhydramine |
1 mg/kg p.o. h.s. |
Day 0 and then every 6 h |
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| Therapy continues every 4 weeks for a total of six cycles.
Prior to institution of each subsequent cycle, the absolute neutrophil count must be >750 cells/μl and platelets must be >75 000 cells/μl |
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| Intra-arterial chemotherapy |
| Melphalan |
|
Slow pulsatile infusion over 30 min |
| 0–2 years old |
3 mg/30 cc |
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| 2–5 years old |
5 mg/30 cc |
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| >5 years old |
7.5 mg/30 cc |
|
| Carboplatin |
30 mg/30 cc |
Slow pulsatile infusion over 30 min |
| Topotecan |
|
Slow pulsatile infusion over 30 min |
| 0–2 years old |
0.5 mg/30 cc |
|
| >2 years old |
1.0 mg/30 cc |
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| Subtenon's chemotherapy |
| Carboplatin |
20 mg/2 cc |
Inject into subtenon's space directly over sclera in area of tumour |
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| Intravitreal chemotherapy |
| Melphalan |
8–30 μg/0.1 cc |
Inject intravitreally through pars plana or clear corneal approach, cryotherapy to injection site, jiggle eye to mix chemotherapy.
Deliver monthly |
| Methotrexate |
400-800 μg/0.1 cc |
Inject intravitreally through pars plana or clear corneal approach, cryotherapy to injection site.
Deliver twice weekly for 1 month, then weekly for 1 month, then monthly for 1 year |
