{"entity":{"id":"paper-siopel-4-dose-dense-cisplatin-high-risk-hepatoblastoma-zsiros-lancet-oncol-2013","kind":"paper","name":"SIOPEL-4: dose-dense cisplatin-based chemotherapy and surgery for high-risk hepatoblastoma","aka":[],"tldr":"Weekly cisplatin with doxorubicin before surgery got almost every child with high-risk hepatoblastoma to respond and three quarters to complete removal of the tumour, with three-year survival of 83 percent in a group that previously did poorly.","summary":"Prospective single-arm feasibility study of the SIOPEL group in 62 children with high-risk hepatoblastoma (39 with lung metastases): dose-dense cisplatin with doxorubicin before surgery (including transplantation and metastasectomy where needed), then carboplatin and doxorubicin.\n\n60 of 61 evaluable patients had a partial response to pre-operative chemotherapy, 46 (74 percent) had complete resection and 49 (79 percent) were in complete remission at the end of therapy. Three-year event-free survival was 76 percent and overall survival 83 percent at a median follow-up of 52 months; 97 percent had grade 3 or 4 haematological toxicity and 71 percent febrile neutropenia.","asOf":"2026-09-22","links":[{"label":"Lancet Oncol 2013","url":"https://doi.org/10.1016/S1470-2045(13)70272-9"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/23831416/"}],"tags":[],"related":[],"cancers":["hepatoblastoma"],"sections":[],"technologies":[],"targets":[],"drugs":["cisplatin","doxorubicin","carboplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["siopel-4"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2013,"doi":"10.1016/S1470-2045(13)70272-9","pmid":"23831416","authors":"Zsiros J, Brugieres L, Brock P, et al.","paperType":"observational","findings":["Complete remission at the end of therapy 79 percent (95% CI 67 to 88).","Partial response to pre-operative chemotherapy in 98 percent; complete resection in 74 percent.","Three-year event-free survival 76 percent (65 to 87) and overall survival 83 percent (73 to 93)."],"whatItMeans":"Dose-dense cisplatin became the SIOPEL standard for high-risk hepatoblastoma and one arm of the international PHITT trial.","caveats":["Single-arm feasibility design with heavy haematological toxicity; hearing loss from cumulative cisplatin is a long-term concern."],"changedPractice":true,"participants":62},"route":"/key-papers/paper-siopel-4-dose-dense-cisplatin-high-risk-hepatoblastoma-zsiros-lancet-oncol-2013/","neighbours":{"cancer":[{"id":"hepatoblastoma","kind":"cancer","name":"Hepatoblastoma","route":"/cancers/hepatoblastoma/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"}],"trial":[{"id":"siopel-4","kind":"trial","name":"SIOPEL-4","route":"/trials/siopel-4/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}