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Open Access Research

Interval compressed vincristine, doxorubicin, cyclophosphamide alternating with ifosfamide, etoposide in patients with advanced Ewing’s and other Small Round Cell Sarcomas

Jeremy Whelan*, Atia Khan, Anand Sharma, Christian Rothermundt, Palma Dileo, Maria Michelagnoli, Beatrice Seddon and Sandra Strausss

Author Affiliations

Department of Oncology, The London Sarcoma Service, University College Hospital London NHS Foundation Trust, 1st Floor Central, 250 Euston Road, London NW1 2PG, UK

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Clinical Sarcoma Research 2012, 2:12  doi:10.1186/2045-3329-2-12

Published: 21 September 2012

Abstract

Background

To evaluate tolerability and maintenance of dose intensity of 2 weekly treatment with vincristine, doxorubicin, cyclophosphamide alternating with ifosfamide, etoposide (VDC/IE) in patients with advanced small round cell sarcomas including Ewing family tumours (EFT), desmoplastic small round cell tumours (DSRCT) and undifferentiated high grade round cell sarcomas (UHGRCS).

Methods

Retrospective review of 16 patients treated at a single centre with VDC/IE. Dose received, treatment delay, toxicity and clinical outcome were recorded for each cycle up to a maximum of 14 cycles.

Results

A total 193 cycles of VDC/IE were administered to 10 patients with EFT, 4 with DSRCT and 2 with UHGRCS. Median age was 22 years with 75% over 18 years. Metastases were present in 14 patients. The mean duration of each cycle was 16.7 days. Febrile neutropenia occurred in 14 % of cycles, and grade 3/4 haematologic toxicity including anaemia and thrombocytopenia in 16 % and 11 % of cycles respectively. Seven patients had a dose reduction. Five patients discontinued VDC/IE early due to toxicity.

Conclusions

This schedule of VDC/IE is feasible in patients with EFT and DSRCT including adults and those with metastases. Its comparison with other standard regimens for these diseases is justified.

Keywords:
Ewing’s sarcoma; Desmoplastic small round cell tumour; Chemotherapy; Sarcoma