Vincristine, Dactinomycin, and Cyclophosphamide in Treating Patients With Embryonal Rhabdomyosarcoma

DISEASE CHARACTERISTICS:

• Diagnosis of embryonal rhabdomyosarcoma

  • Primary operation for pathological diagnosis within the past 42 days

  • The following variants are eligible:

    • Botryoid
    • Spindle cell
    • Anaplastic

• Meets 1 of the following stage criteria:

  • Stage I, clinical group II (N1)

    • Favorable site
    • Any tumor size
    • Microscopic residual disease
    • Lymph nodes clinically positive

  • Stage I, clinical group III (N1)

    • Favorable site (orbit only)
    • Any tumor size
    • Gross residual disease
    • Lymph nodes clinically positive

  • Stage I, clinical group III (N0, NX, N1)

    • Favorable site (except orbit)
    • Any tumor size
    • Gross residual disease
    • Lymph nodes clinically negative, involvement unknown, or positive

  • Stage II, clinical group II (N0, NX)

    • Unfavorable site
    • Small tumor (≤ 5 cm in diameter)
    • Microscopic residual disease

  • Stage III, clinical group I or II (N0, NX, N1)

    • Unfavorable site
    • Small tumor (≤ 5 cm in diameter) with positive nodes or large tumor (> 5 cm in diameter) with any lymph nodes status
    • Completely resected or microscopic residual disease

PATIENT CHARACTERISTICS:

Performance status

• 0-3

Life expectancy

• Not specified

Hematopoietic

• WBC ≥ 2,000/mm^3
• Platelet count ≥ 100,000/mm^3
• Hemoglobin ≥ 7.5 g/dL

Hepatic

• SGOT and SGPT ≤ 2.5 times upper limit of normal (ULN)
• Bilirubin ≤ 2.5 times ULN
• Bile acid ≤ 2.5 times ULN

Renal

• Creatinine based on age as follows:

  • ≤ 0.8 mg/dL (for patients < 5 years of age)
  • ≤ 1.2 mg/dL (for patients 5-9 years of age)
  • ≤ 1.5 mg/dL (for patients ≥ 10 years of age)

Cardiovascular

• No severe heart disease

Other

• Not pregnant or nursing
• No uncontrolled infection
• Must have acceptable organ function for age
• No other malignancy within the past 5 years
• No hypersensitivity attributed to study drugs
• No Charcot-Marie-Tooth disease or chickenpox

PRIOR CONCURRENT THERAPY:

Chemotherapy

• No prior anticancer chemotherapy

Endocrine therapy

• Prior anticancer steroids allowed

Radiotherapy

• Prior emergency radiotherapy allowed within the past 2 weeks

Other

• No concurrent pentostatin