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

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18 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 languageEnglish (US)
Pages (from-to)99-106
Number of pages8
JournalEuropean Journal of Cancer
Volume45
Issue number1
DOIs
StatePublished - Jan 2009

Keywords

  • Carboplatin
  • Creatinine
  • Glomerular filtration rate
  • Ifosfamide
  • Kidney neoplasms
  • Nephrectomy
  • Renal function

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Daw, N. C., Gregornik, D., Rodman, J., Marina, N., Wu, J., Kun, L. E., Jenkins, J. J., McPherson, V., Wilimas, J., & Jones, D. P. (2009). Renal function after ifosfamide, carboplatin and etoposide (ICE) chemotherapy, nephrectomy and radiotherapy in children with wilms tumour. European Journal of Cancer, 45(1), 99-106. https://doi.org/10.1016/j.ejca.2008.09.017