The use of ifosfamide, carboplatin, and etoposide in children with solid tumors.

A multidisciplinary approach including surgery, radiotherapy, chemotherapy, and, recently, biotherapy and immunotherapy has significantly increased the prognosis for a large variety of pediatric solid tumors over the past two decades. Ifosfamide, carboplatin, and etoposide, used singly and in combination, have demonstrated efficacy in a number of these malignancies. The combination of all three agents (ICE) has produced overall response rates (complete response + partial response) in excess of 50% in a wide variety of recurrent or persistent pediatric solid tumors. Until recently, ICE administration was limited by significant hematopoietic toxicities. However, the use of hematopoietic growth factors alone and in combination appears to enhance hematopoietic recovery and may allow further dose intensification of ICE in children with recurrent solid tumors.