Replacing Actinomycin-D with Carboplatin for Newly Diagnosed Rhabdomyosarcoma


Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric age group.All patients with RMS regardless of their initial stage or group receive combination chemotherapy as ‘standardtherapy’ consisting of vincristine, actinomycin-D and cyclophosphamide. Actinomycin-D was not readily availablein Turkey at one time. Carboplatin was used instead in order to prevent delays in treatment. The aim of thisreport is to present the results of patients with rhabdomyosarcoma receiving carboplatin or actinomycin-Dtherapy. Materials and
Methods: Twenty four patients with rhabdomyosarcoma treated between December 2000and June 2011 were included in this retrospective study. The patients were treated according to InternationalRhabdomyosarcoma Study Group guidelines. Eleven patients were treated with actinomycin-D and 13 withcarboplatin (250 mg/m2/dose for 2 days). The two groups were then compared in terms of 2- and 5-year overallsurvival (OS) and hematological and non-hematological toxicities.
Results: Age, sex, stage and the mean durationof follow-up were similar in both groups (p>0.05 ). Two- and five-year OS levels were 68.2% in the carboplatingroup and 78.0% and 40.0%, respectively, in the actinomycin-D group. There was no statistical difference inthe number of febrile episodes (p=0.86 ) and no other hematological and non-hematological adverse effects wererecorded in both groups.
Conclusions: The findings show that carboplatin can be used as an alternative drug inthe primary treatment of rhabdomyosarcoma in the event that actinomycin-D is unavailable or not tolerated.