SIOPEL recommends the treatment strategy for Hepatoblastoma patients not entered into a clinical trial:
Standard Risk Tumours: 4 cycles of CISPLATIN preoperative chemotherapy followed by surgical resection and 2 post operative cycles of therapy.
High risk tumours: the preoperative dose intensive “superPLADO” arm of the SIOPEL 3 study (Zsiros et al 2010 J Clin Oncol 28:2584). We would also recommend consultation at the time of diagnosis with a specialist liver surgery/transplant service.
Very high risk tumours: These tumours are defined by the presence of metastatic disease (usually lung) or very low AFP (<100 ng/ml). They should be treated with the approach utilised in the SIOPEL4 protocol with dose-intensive weekly cisplatin/doxorubicin induction therapy. This is an experimental regimen with limited pilot data shortly to be published.
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