The United Kingdom Children’s Cancer Study Group’s Second Germ Cell Tumor Study: Carboplatin, Etoposide, and Bleomycin Are Effective Treatment for Children With Malignant Extracranial Germ Cell Tumors, With Acceptable Toxicity

• DOI: 10.1200/jco.2000.18.22.3809
• Publication Date: 2017-02-24T07:10:13Z
• Authors: J.R. Mann; F. Raafat; K. Robinson; J. Imeson; P. Gornall; M. Sokal; E. Gray; P. McKeever; J. Hale; S. Bailey; A. Oakhill
• Keywords: Carboplatin; Immature teratoma; Germinoma

PURPOSE: To evaluate carboplatin, etoposide, and bleomycin (JEB) in children with malignant extracranial germ cell tumors (GCTs). PATIENTS AND METHODS: Malignant GCTs aged 0 to 16 years were excised without major morbidity or otherwise biopsied. Stage I testicular some ovarian resected monitored alpha-fetoprotein (AFP) (“watch-and-wait” approach). Patients recurrent stage disease all other patients received JEB (etoposide 120 mg/m 2 on days 1 through 3, carboplatin 600 day 2, 15 3). Courses administered every 3 4 weeks until remission, then two more courses given. Chemotherapy toxicities assessed using World Health Organization Brock grading. RESULTS: Between January 1989 December 1997, 192 registered. Eight excluded because either there was no histologic diagnosis (n = 3) chemotherapy given off-study 5). The remaining 184 had germinoma 20), teratoma 55), embryonal carcinoma 1), yolk sac tumor 107), choriocarcinoma 1). Forty-seven treated surgery alone, 137 JEB. 5-year survival rate March 1999 for 93.2% (95% confidence interval [CI], 87.9% 96.3%); the JEB-treated patients, it 90.9% CI, 83.9% 95.0%), an event-free of 87.8% 81.1% 92.4%). median follow-up after treatment 53 months (range, 109 months); number five three eight). Site, stage, AFP level prognostic significance. Nonfatal hematologic toxicity common, but deafness pulmonary renal rare. One child died a thoracic bronchopulmonary dysplasia, another acute myeloid leukemia. CONCLUSION: Conservative surgery, watch-and-wait approach complete excision, those requiring produced high cure rates few serious complications.