{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:35:45Z","timestamp":1791318945398,"version":"4.3.1"},"reference-count":37,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"32","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2009,11,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Ifosfamide is widely used in pediatric oncology but its nephrotoxicity may become a significant issue in survivors. This study is aimed at evaluating the incidence of late renal toxicity of ifosfamide and its risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Of the 183 patients prospectively investigated for renal function, 77 treated for rhabdomyosarcoma, 39 for other soft tissue sarcoma, 39 for Ewing's sarcoma, and 28 for osteosarcoma were investigated at least 5 years after treatment. No patients had received cisplatin and\/or carboplatin. Glomerular and tubular functions were graded according to the Skinner system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median dose of ifosfamide was 54 g\/m<jats:sup>2<\/jats:sup>(range, 18 to 117 g\/m<jats:sup>2<\/jats:sup>). After a median follow-up of 10 years, 89.5% of patients had normal tubular function, and 78.5% had normal glomerular function rate (GFR). Serum bicarbonate and calcium were normal in all patients. Hypomagnesemia was observed in 1.2% and hypophosphatemia in 1%. The tubular threshold for phosphate was reduced in 24% of the patients (grade 1 in 15%, grade 2 in 8%, and grade 3 in 0.5%). Glycosuria was detected in 37% of the patients but was more than 0.5 g\/24 hours in only 5%. Proteinuria was observed in 12%. Ifosfamide dose and interval from therapy to investigations were predictors of tubulopathy in univariate and multivariate analysis. In a multivariate analysis, an older age at diagnosis and the length of interval since treatment had independent impacts on the risk of abnormal GFR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Renal toxicity is moderate with a moderate dose of ifosfamide. However, since it can be permanent and can get worse with time, repeated long-term evaluations are important, and this risk should be balanced against efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2008.17.5257","type":"journal-article","created":{"date-parts":[[2009,10,14]],"date-time":"2009-10-14T07:09:08Z","timestamp":1255504148000},"page":"5350-5355","source":"Crossref","is-referenced-by-count":121,"title":["Long-Term Evaluation of Ifosfamide-Related Nephrotoxicity in Children"],"prefix":"10.1200","volume":"27","author":[{"given":"Odile","family":"Oberlin","sequence":"first","affiliation":[{"name":"From Pediatrics and Biostatistics Departments, and L'Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Institut Gustave Roussy, Villejuif; Pediatric Nephrology, Centre Hospitalier Universitaire (CHU) Necker; Pediatrics, Institut Curie; H\u00f4pital Trousseau, Paris; Pediatrics, Centre L\u00e9on B\u00e9rard, Lyon; Centre Oscar Lambret, Lille; H\u00f4pital de La Timone, Marseille; CHU, Nancy; H\u00f4pital Purpan, Toulouse; CHU, Reims; CHU A. Michalon, Grenoble; CHU L'Archet, Nice; and H\u00f4pital M\u00e8re-Enfant, Nantes, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumaya","family":"Fawaz","sequence":"additional","affiliation":[{"name":"From Pediatrics and Biostatistics Departments, and L'Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Institut Gustave Roussy, Villejuif; Pediatric Nephrology, Centre Hospitalier Universitaire (CHU) Necker; Pediatrics, Institut Curie; H\u00f4pital Trousseau, Paris; Pediatrics, Centre L\u00e9on B\u00e9rard, Lyon; Centre Oscar Lambret, Lille; H\u00f4pital de La Timone, Marseille; CHU, Nancy; H\u00f4pital Purpan, Toulouse; CHU, Reims; CHU A. 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