Standard treatment options:
Palliative chemotherapy with: Fluorouracil (5-FU).[1,2,3]Epirubicin, cisplatin, and 5-FU (ECF).[4,5]Epirubicin, oxaliplatin, and capecitabine (EOX).Cisplatin and 5-FU (CF).[7,3]Docetaxel, cisplatin, and 5-FU.Etoposide, leucovorin, and 5-FU (ELF).5-FU, doxorubicin, and methotrexate (FAMTX).
Trastuzumab, cisplatin, and either 5-FU or capecitabine in patients with HER2-positive tumors (3+ on immunohistochemistry [IHC] or fluorescence in situ...
Added text about the results of the St. Jude Total XV study regarding the risk of cognitive deficits following CNS-directed therapy with chemotherapy alone and the need for longitudinal follow-up (cited Conklin et al. as reference 20).
Revised Table 7 to include mIBG as a predisposing therapy for thyroid nodules.
Added Paris et al. as reference 65.
Late Effects of the Musculoskeletal System
Revised text to state that symptomatic osteonecrosis characterized by pain, joint swelling, and reduced mobility typically presents during the first 2 years of therapy, particularly in the case of acute lymphoblastic leukemia. Also added text to state that in some series, up to 40% of patients required some type of surgical procedure (cited Mattano et al. as reference 54).
Late Effects of the Special Senses
Added text about a study that evaluated audiological outcomes among 60 retinoblastoma survivors treated with nonmyeloablative systemic carboplatin and vincristine and reported on the cumulative incidence of hearing loss in those patients; younger age at the start of treatment was the only significant predictor of hearing loss (cited Qaddoumi et al. as reference 8).
This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.