Table 1.
Treatment Schema and Chemotherapy Doses
| Week | Treatment |
|---|---|
| RP1 | |
| 1* | V, irin |
| 2 | V |
| 3 | V |
| 4 | V, irin |
| 5 | V |
| 6 | EVAL |
| RP2 | |
| 7 | VDC |
| 8 | V |
| 9 | IE |
| 10 | |
| 11 | VDC |
| 12 | V |
| 13 | IE |
| 14 | |
| 15 | VDC |
| 16 | V |
| 17 | IE |
| 18 | |
| 19 | EVAL |
| RP3 | |
| 20 | RT, V, irin |
| 21 | RT, V |
| 22 | RT, V |
| 23 | RT, V, irin |
| 24 | RT, V |
| 25 | RT |
| 26 | IE |
| 27 | |
| 28 | VDC |
| 29 | V |
| 30 | IE |
| 31 | |
| 32 | VDC |
| 33 | V |
| 34 | EVAL |
| RP4 | |
| 35 | VAC |
| 36 | |
| 37 | |
| 38 | VAC |
| 39 | |
| 40 | |
| 41 | VAC |
| 42 | V |
| 43 | V |
| 44 | VAC |
| 45 | |
| 46 | |
| 47† | V, irin |
| 48 | V |
| 49 | |
| 50 | V, irin |
| 51 | V |
| 52 | |
| 53 | |
| 54 | EVAL |
NOTE. Mesna will be used with cyclophosphamide and ifosfamide. Filgrastim will be used in VAC, VDC, and IE cycles. Sargramostim or peg-filgrastim should not be used. If there is an age change during treatment use the new appropriate age dosing in the next cycle.
Abbreviations: A, dactinomycin; C, cyclophosphamide; D, doxorubicin; E, etoposide; I, ifosfamide; irin, irinotecan; IV, intravenously; L, XXXX; RP, reporting period; RT, radiation therapy; V, vincristine.
Patients with evidence of intracranial extension should receive RT starting at week 1.
Previously unirradiated metastatic sites may be irradiated during weeks 47-51.
If tolerated (ie, no delay in administration of the next cycle because of delayed count recovery or delayed resolution of other toxicities and no serious toxicities), consider increasing to 75% and then to 100% of the calculated full dose.