Outpatient and Home Chemotherapy with Novel Local Control Strategies in Desmoplastic Small Round Cell Tumor

Table 1

Outpatient DSRCT chemotherapy: doses and schedule.

Agent	Dose	Route	Comments
Preadjuvant phase of therapy (every 3 weeks × 4 cycles)
Vincristine	1.5 mg/m^2	iv over 2–15 minutes	Max dose 2 mg; day 1 only
Etoposide	150 mg/m^2	iv over 1 hour	Day 1 only
Dexrazoxane	750 mg/m^2	iv over 15 minutes	Just before doxorubicin
Doxorubicin	75 mg/m^2	iv over 15 minutes	Day 1 only
Ifosfamide	3 g/m^2	iv daily × 3	Continuous infusion. Mix
+ MESNA	3 g/m^2	iv daily × 4	with MESNA in 240–360 mL NS days 1, 2, 3.
			MESNA only day 4 (portable pump as outpatient)
CHPP phase
Cisplatin	100 mg/m^2	Intraperitoneal	As continuous peritoneal perfusion at 42^°C × 1.5 hr
Radio sensitization during RT
Temozolomide	75 mg/m^2	po	Daily × 5 × 2 weeks
Bevacizumab	5 mg/kg	iv	q2 weeks × 2 doses begin before RT
Pre-RT (2 cycles) and post-RT (10 cycles)
Temozolomide	100 mg/m^2	po	Daily × 5 each month
Irinotecan	10 mg/m^2	iv	Daily × 5 × 2 weeks each month; may do as home infusions
Chronic continuation chemotherapy
Valproate	500 mg/m^2	po	Daily; divide BID monitor level <100
Rapamycin	2 mg/m^2	po	Daily round to nearest mg
Cyclophosphamide	25 mg	po	If >1.5 m^2 may give 50 mg daily. Monitor cbc