{"entity":{"id":"paper-siopel-3-cisplatin-vs-plado-standard-risk-hepatoblastoma-perilongo-nejm-2009","kind":"paper","name":"SIOPEL-3: cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma","aka":[],"tldr":"Children with standard-risk hepatoblastoma were cured just as often with cisplatin alone as with cisplatin plus doxorubicin, and had far fewer severe side effects, so doxorubicin can be left out.","summary":"International randomised trial of the SIOPEL group: 255 children with standard-risk hepatoblastoma were randomised to pre- and post-operative cisplatin alone (n 126) or cisplatin plus doxorubicin (n 129) with delayed resection.\n\nComplete resection was achieved in 95 and 93 percent; three-year event-free survival was 83 and 85 percent and overall survival 95 and 93 percent (median follow-up 46 months). Acute grade 3 or 4 adverse events occurred in 20.6 percent with cisplatin alone against 74.4 percent with the combination.","asOf":"2026-09-22","links":[{"label":"N Engl J Med 2009","url":"https://doi.org/10.1056/NEJMoa0810613"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/19846851/"}],"tags":[],"related":[],"cancers":["hepatoblastoma"],"sections":[],"technologies":[],"targets":[],"drugs":["cisplatin","doxorubicin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["siopel-3"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2009,"doi":"10.1056/NEJMoa0810613","pmid":"19846851","authors":"Perilongo G, Maibach R, Shafford E, et al.","paperType":"rct","findings":["Complete resection 95 percent with cisplatin versus 93 percent with cisplatin plus doxorubicin (difference 1.4 percent, 95% CI -4.1 to 7.0).","Three-year event-free survival 83 versus 85 percent; overall survival 95 versus 93 percent.","Grade 3 or 4 acute adverse events 20.6 versus 74.4 percent."],"whatItMeans":"Cisplatin monotherapy with delayed surgery is the standard for standard-risk hepatoblastoma; later SIOPEL-6 added sodium thiosulfate to protect hearing.","caveats":["Standard-risk disease only; high-risk patients need intensified regimens such as SIOPEL-4."],"changedPractice":true,"participants":255},"route":"/key-papers/paper-siopel-3-cisplatin-vs-plado-standard-risk-hepatoblastoma-perilongo-nejm-2009/","neighbours":{"cancer":[{"id":"hepatoblastoma","kind":"cancer","name":"Hepatoblastoma","route":"/cancers/hepatoblastoma/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"}],"trial":[{"id":"siopel-3","kind":"trial","name":"SIOPEL-3","route":"/trials/siopel-3/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}