Costello Syndrome and Umbilical Ligament Rhabdomyosarcoma in Two Pediatric Patients: Case Reports and Review of the Literature

Table 4

Chemotherapy of pediatric patients with umbilical ligament rhabdomyosarcoma.

PT number	Chemotherapy protocol
1-2	No ChT [26, 28]
3	After establishment of the final diagnosis, he was treated with combined ChT, including VCR, ACD, and CTX [29]
	Initially IFOS, ACD, and VCR. After 4 courses, CTX was substituted for IFOS because of hemorrhagic cystitis. Tx complicated by recurrent episodes of moderately severe diarrhoea and febrile neutropenia requiring readmission to hospital. Tx was completed after six courses of ChT [7]
5	NDF [30]
6	PT started induction of ChT 2 weeks after S. Induction regimen included 9 cycles of IVA (IFOS, VCR, and ACD) that were well tolerated with minimal systemic complications (Tx 953 of the MMT 95 SIOP protocol for RMS) [27]
	ChT according to the cooperative soft tissue sarcoma protocol (CWS-2002 P) was well tolerated by the PT [24]
8	Adjuvant ChT with 10 cycles of IFOS, VCR, and ACD [31]
9	Adjuvant ChT with 6 cycles of IFOS, VCR, and VP-16 and 9 cycles of VCR, ACD, CTX/ACD, and CTX [31]
10	Neoadjuvant ChT with 6 cycles of IFOS, VCR, and ACD and adjuvant ChT with 3 cycles of IFOS, VCR, and ACD [31]
11	Neoadjuvant ChT with 1 cycle of CTX, VCR, and PRED, 2 cycles IFOS, VCR, and ACD, and 4 cycles of IFOS, VCR, ACD, and DOX and adjuvant ChT with 3 cycles of IFOS, VCR, and ACD [31]
12	Neoadjuvant ChT with 1 cycle of CTX, VCR, and PRED and 5 cycles of IFOS, VCR, ACD, and DOX and adjuvant ChT with 2 cycles of IFOS, VCR, ACD, and DOX and 1 cycle of IFOS, VCR, and ACD [31]
13	Neoadjuvant ChT with 2 cycles of VCR, ACD, and CTX + and 3 cycles of IFOS, VCR, ACD, and DOX and adjuvant ChT with 3 cycles of IFOS, VCR, and ACD [31]
14	Neoadjuvant ChT with 4 cycles of IFOS, VCR, ACD, and DOX and adjuvant ChT with 5 cycles of IFOS, VCR, ACD [31]
15	Neoadjuvant ChT with 4 cycles of IFOS, VCR, ACD, DOX, 3 cycles of IFOS, VCR, ACD and adjuvant ChT with 1 cycle of IFOS, VCR, ACD, 1 cycle of IFOS, VCR [31]
	ChT in the standard risk group protocol EpSSG RMS 2005 subgroup D, 3 preoperative cycles of IFOS (2 doses at 100 mg/kg), VCR (0.05 mg/kg) and ACD (0.05 mg/kg)
	ChT (postoperative 15 days) in the standard risk group protocol EpSSG RMS 2005 subgroup B (Stage I), cycles of IFOS (2 doses of 3 g/m^2/d), VCR (1.5 mg/m^2) and ACD (1.5 mg/m^2) was initiated

ACD, actinomycin D; ChT, chemotherapy; CTX, cyclophosphamide; CWS, Cooperative Weichteilsarkom Studie (Cooperative Soft Tissue Sarcoma Study); DOX, Doxorubicin; EpSSG, European pediatric Soft tissue sarcoma Study Group; IFOS, ifosfamide; MMT, malignant mesenchymal tumor; NDF, no data found; PRED, prednisone; PT, patient; RMS, rhabdomyosarcoma; S, surgery; SIOP, Société Internationale D’Oncologie Pédiatrique (International Society of Pediatric Oncology); Tx, treatment; VCR, vincristine; VP-16, etoposide. Patients with Costello syndrome.