Chemotherapy in Treating Children With Recurrent or Refractory Sarcomas

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed malignancy that is relapsed or refractory to conventional therapy at original diagnosis including:
• •* Brain tumors
• •* Gliomas or astrocytomas
• •* Medulloblastomas or primitive neuroectodermal tumor (PNET) in CNS
• •* (Brain tumor stratum closed to accrual effective 07/02/2001)
• •* Sarcomas
• •* Soft tissue sarcoma (undifferentiated sarcoma, embryonal or alveolar rhabdomyosarcoma (RMS), or non-RMS soft tissue sarcoma)
• •* Osteosarcoma
• •* Ewing's sarcoma/peripheral PNET tumors
• •* Neuroblastoma
• •* (Neuroblastoma stratum closed to accrual effective 07/02/2001)
• •Histology requirement waived for brain stem tumors (Brain tumor stratum closed to accrual effective 07/02/2001)
• •Measurable disease documented by clinical, radiographic, or histologic criteria
• •Lesions in previously irradiated fields may be used to assess tumor response if there has been evidence of subsequent tumor growth in those fields
• •No bone marrow metastases with granulocytopenia and/or thrombocytopenia
• •PATIENT CHARACTERISTICS:
• •Age:
• •30 days to 21 years at diagnosis
• •Performance status:
• •ECOG 0-2
• •Life expectancy:
• •More than 2 months
• •Hematopoietic:
• •Absolute neutrophil count at least 1,000/mm3
• •Hemoglobin at least 10.0 g/dL (may receive RBC transfusions)
• •Platelet count at least 100,000/mm3 (50,000/mm3 if post bone marrow transplantation) (transfusion independent)
• •Hepatic:
• •Bilirubin no greater than 1.5 times normal
• •SGOT or SGPT less than 2.5 times normal
• •Renal:
• •Creatinine no greater than 1.5 times normal OR
• •Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min
• •Neurologic:
• •No greater than grade 2 CNS toxicity OR
• •Stable CNS status for brain tumors (Brain tumor stratum closed to accrual effective 07/02/2001)
• •Seizure disorders allowed if well-controlled with anticonvulsants
• •Other:
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •At least 3 months since prior bone marrow transplantation and recovered
• •At least 2 weeks since prior cytokines and recovered
• •No concurrent filgrastim (G-CSF) or other cytokines
• •No concurrent immunomodulating agents
• •Chemotherapy:
• •At least 2 weeks since prior chemotherapy (4 weeks for nitrosoureas) and recovered
• •No prior topotecan or other camptothecins
• •No other concurrent anticancer chemotherapy
• •Endocrine therapy:
• •Concurrent corticosteroids for CNS tumors with increased intracranial pressure allowed (Brain tumor stratum closed to accrual effective 07/02/2001)
• •Radiotherapy:
• •At least 2 months since prior craniospinal radiotherapy or radiotherapy to more than 50% of the bone marrow and recovered
• •Concurrent radiotherapy to localized painful lesions allowed provided that at least 1 measurable lesion is not irradiated
• •Other:
• •Recovered from any other prior therapy