Rhabdomyosarcoma, pediatric - historical

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the pediatric rhabdomyosarcoma page for current regimens.
Last updated on 2024-07-23:9 regimens on this page
9 variants on this page
=Unstratified, all lines of therapy=
==Dactinomycin monotherapy==
===Regimen===
Study 	Dates of enrollment	Evidence
Pinkel 1959	Not reported 	Pilot
====Chemotherapy====
*Dactinomycin (Cosmegen) of varying dosages
===References===
# Pinkel D. Actinomycin D in childhood cancer; a preliminary report. Pediatrics. 1959 Feb;23(2):342-7. link to original article EuroPMC
=High-risk, all lines of therapy=
==COG D9802 VCPT Alternating with VAC Arm==
Study 	Dates of enrollment	Evidence
Pappo et al. 2007 (COG D9802)	1999-09 to 2000-11 	Phase 2
===Irinotecan window===
====Chemotherapy, Week 0 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 1 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 2 Off Chemo====
====Chemotherapy, Week 3 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 4 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
Evaluation during week 5, followed by:
===Induction===
====Chemotherapy, Week 6 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 6====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 7 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 10 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 11 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 12 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 12====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 13 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
Evaluation during week 14, followed by:
====Chemotherapy, Week 15 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 16 (VC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 16====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 17 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 18 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 19 (VC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 19====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 20 through 22 Off Chemo====
====Chemotherapy, Week 23 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 23====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 24 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 25 (Eval/Vincristine)====
*Evaluation Week
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
===Continuation===
====Chemotherapy, Week 26 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 27 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 28 Off Chemo====
====Chemotherapy, Week 29 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 29====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 30 through 31 Off Chemo====
====Chemotherapy, Week 32 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 33 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 34 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 35 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 35====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 36 through 37 Off Chemo====
====Chemotherapy, Week 38 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 39 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 40 Off Chemo====
====Chemotherapy, Week 41 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 41====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
Evaluation during week 44
===References===
# COG D9802: Pappo AS, Lyden E, Breitfeld P, Donaldson SS, Wiener E, Parham D, Crews KR, Houghton P, Meyer WH. Two Consecutive Phase II Window Trials of Irinotecan Alone or in Combination With vincristine for the Treatment of Metastatic Rhabdomyosarcoma: The Children's Oncology Group. J Clin Oncol. 2007 Feb 1;25(4):362-9. link to original article EuroPMC NCT00003955
==COG D9802 VAC Alone Arm==
Study 	Dates of enrollment	Evidence
Pappo et al. 2007 (COG D9802)	1999-09 to 2000-11 	Phase 2
===Irinotecan window===
====Chemotherapy, Week 0 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 1 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 2 Off Chemo====
====Chemotherapy, Week 3 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 4 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
Evaluation during week 5, followed by:
===Induction===
====Chemotherapy, Week 6 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 6====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 7 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 10 (VCPT)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 40 mg/day) IV over 60 minutes once per day on days 1 to 5, given after vincristine on day 1
====Chemotherapy, Week 11 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 12 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 12====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 13 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
Evaluation during week 14, followed by:
====Chemotherapy, Week 15 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 16 (VC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 16====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 17 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 18 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 19 (VC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 19====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 20 through 22 Off Chemo====
====Chemotherapy, Week 23 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 23====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 24 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 25 (Evaluation/Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
===Continuation===
====Chemotherapy, Week 26 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 26====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 27 (VCR)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 28 Off Chemo====
====Chemotherapy, Week 29 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 29====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 30 through 31 Off Chemo====
====Chemotherapy, Week 32 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 32====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 33 (VCR)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 34 (Vincristine)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 35 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 35====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 36 through 37 Off Chemo====
====Chemotherapy, Week 38 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 38====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
====Chemotherapy, Week 39 through 40 Off Chemo====
====Chemotherapy, Week 41 (VAC)====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 41====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
Evaluation during week 44
===References===
# COG D9802: Pappo AS, Lyden E, Breitfeld P, Donaldson SS, Wiener E, Parham D, Crews KR, Houghton P, Meyer WH. Two Consecutive Phase II Window Trials of Irinotecan Alone or in Combination With vincristine for the Treatment of Metastatic Rhabdomyosarcoma: The Children's Oncology Group. J Clin Oncol. 2007 Feb 1;25(4):362-9. link to original article EuroPMC NCT00003955
=Low-risk, all lines of therapy=
==COG D9602 Subgroup A Clinical Group 1 protocol==
===Regimen===
Study 	Dates of enrollment 	Evidence
Raney et al. 2011 (IRSG D9602)	1997-09-01 to 2004-09-17	Phase 2
Note: evaluation is performed at the end of each 12-week cycle.
====Chemotherapy, Week 0====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Chemotherapy, Week 1====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 2====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 3====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Chemotherapy, Week 4====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 5====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 6====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Chemotherapy, Week 7====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9====
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
12-week cycle for 4 cycles; beginning on weeks 0, 12, 24, 36
===References===
#IRSG D9602: Raney RB, Walterhouse DO, Meza JL, Andrassy RJ, Breneman JC, Crist WM, Maurer HM, Meyer WH, Parham DM, Anderson JR. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011 Apr 1;29(10):1312-8. link to original article link to PMC article EuroPMC NCT00002995
==COG D9602 Subgroup A Clinical Group 2 protocol==
===Regimen===
Study 	Dates of enrollment 	Evidence
Raney et al. 2011 (IRSG D9602)	1997-09-01 to 2004-09-17	Phase 2
Note: Evaluation occurs at the end of each 12-week cycle.
====Chemotherapy, Week 0====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Chemotherapy, Week 1====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 2====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 3====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Radiotherapy, Week 3====
*External beam radiotherapy 3600 cGy given once per day in 20 divided fractions
====Chemotherapy, Week 4====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 5====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 6====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 7====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9====
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
12-week cycle for 4 cycles; beginning on weeks 0, 12, 24, 36
===References===
#IRSG D9602: Raney RB, Walterhouse DO, Meza JL, Andrassy RJ, Breneman JC, Crist WM, Maurer HM, Meyer WH, Parham DM, Anderson JR. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011 Apr 1;29(10):1312-8. link to original article link to PMC article EuroPMC NCT00002995
==COG D9602 Subgroup A Clinical Group 3 protocol==
===Regimen===
Study 	Dates of enrollment 	Evidence
Raney et al. 2011 (IRSG D9602)	1997-09-01 to 2004-09-17	Phase 2
Note: Evaluation occurs at the end of each 12-week cycle.
====Chemotherapy, Week 0====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Chemotherapy, Week 1====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 2====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 3====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
====Radiotherapy, Week 3====
*External beam radiotherapy 4500 cGy given once per day in 25 divided fractions
====Chemotherapy, Week 4====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 5====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 6====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 7====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9====
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
12-week cycle for 4 cycles; beginning on weeks 0, 12, 24, 36
===References===
#IRSG D9602: Raney RB, Walterhouse DO, Meza JL, Andrassy RJ, Breneman JC, Crist WM, Maurer HM, Meyer WH, Parham DM, Anderson JR. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011 Apr 1;29(10):1312-8. link to original article link to PMC article EuroPMC NCT00002995
==COG D9602 Subgroup B Clinical Group 1 protocol==
===Regimen===
Study 	Dates of enrollment 	Evidence
Raney et al. 2011 (IRSG D9602)	1997-09-01 to 2004-09-17	Phase 2
Note: Evaluation occurs at the end of each 12-week cycle.
====Chemotherapy, Week 0====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 0====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 1====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 2====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 3====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 3====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 4====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 5====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 6====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 6====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 7====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9====
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 9====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after AC completion and continued for 10 days for 10 days or until ANC greater than 2000/μL
12-week cycle for 4 cycles; beginning on weeks 0, 12, 24, 36
===References===
#IRSG D9602: Raney RB, Walterhouse DO, Meza JL, Andrassy RJ, Breneman JC, Crist WM, Maurer HM, Meyer WH, Parham DM, Anderson JR. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011 Apr 1;29(10):1312-8. link to original article link to PMC article EuroPMC NCT00002995
==COG D9602 Subgroup B Clinical Group 2 protocol==
===Regimen===
Study 	Dates of enrollment 	Evidence
Raney et al. 2011 (IRSG D9602)	1997-09-01 to 2004-09-17	Phase 2
Note: Evaluation occurs at the end of each 12-week cycle.
====Chemotherapy, Week 0====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 0====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 1====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 2====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 3====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 3====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days for 10 days or until ANC greater than 2000/μL
====Radiotherapy, Week 3====
*External beam radiotherapy 3600 cGy given once per day in 20 divided fractions
====Chemotherapy, Week 4====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 5====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 6====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 6====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 7====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9====
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 9====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after AC completion and continued for 10 days for 10 days or until ANC greater than 2000/μL
12-week cycle for 4 cycles; beginning on weeks 0, 12, 24, 36
===References===
#IRSG D9602: Raney RB, Walterhouse DO, Meza JL, Andrassy RJ, Breneman JC, Crist WM, Maurer HM, Meyer WH, Parham DM, Anderson JR. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011 Apr 1;29(10):1312-8. link to original article link to PMC article EuroPMC NCT00002995
==COG D9602 Subgroup B Clinical Group 3 protocol==
===Regimen===
Study 	Dates of enrollment 	Evidence
Raney et al. 2011 (IRSG D9602)	1997-09-01 to 2004-09-17	Phase 2
Note: Evaluation occurs at the end of each 12-week cycle.
====Chemotherapy, Week 0====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 0====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 1====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 2====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 3====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 3====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days or until ANC greater than 2000/μL
====Radiotherapy, Week 3====
*External beam radiotherapy 4500 cGy given once per day in 25 divided fractions
====Chemotherapy, Week 4====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 5====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 6====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 6====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after VAC completion and continued for 10 days or until ANC greater than 2000/μL
====Chemotherapy, Week 7====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 8====
*Vincristine (Oncovin) by the following age-based criteria:
**3 years old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
**1 up to 3 years old: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
**Younger than 1 year old: 0.025 mg/kg IV push over 1 minute once on day 1
====Chemotherapy, Week 9====
*Dactinomycin (Cosmegen) by the following age-based criteria:
**1 year old or older: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
**Younger than 1 year old: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
*Cyclophosphamide (Cytoxan) by the following age-based criteria:
**3 years old or older: 2200 mg/m2 IV over 30 to 60 minutes once per day on day 1
**1 year old or older: 73 mg/kg IV infusion over 30 to 60 minutes once on day 1
**Younger than 1 year old: 36 mg/kg IV infusion over 30 to 60 minutes once on day 1
====Supportive Medications, Week 9====
*Mesna (Mesnex) by the following age-based criteria:
**3 years old or older: 440 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1 
**1 year old or older: 14.6 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
**Younger than 1 year old: 7.2 mg/m2 IV infusion at hour 0, 4, and 8 from the start of each cyclophosphamide infusion on day 1
*Filgrastim (Neupogen) 5 mcg/kg SC or IV (per institutional policy) once per day starting 24 hours after AC completion and continued for 10 days or until ANC greater than 2000/μL
12-week cycle for 4 cycles; beginning on weeks 0, 12, 24, 36
===References===
#IRSG D9602: Raney RB, Walterhouse DO, Meza JL, Andrassy RJ, Breneman JC, Crist WM, Maurer HM, Meyer WH, Parham DM, Anderson JR. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011 Apr 1;29(10):1312-8. link to original article link to PMC article EuroPMC NCT00002995
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