Chemotherapy in Treating Children With Recurrent or Refractory Sarcomas

You may be eligible if

• 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