Timeline of major changes in CT
The standard of care today is a 5-6 drugs regimen of
vincristine, doxorubicin, cyclophosphamide, actinomycin-
D, ifosfamide, and etoposide
1970
Today
Dactinomycin, cyclophosphamide, vincristine
Doxorubicin + VAC (IESS-I Study)
High-dose doxorubicin and high-dose cyclophosphamide
(IESS-II Study)
Ifosfamide and etoposide + VACA (vincristine, doxorubicin ,
cyclophosphomide, and dactinomycin (IESS-III Study)




