Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis

The survival of children with malignant germ cell tumor (GCT) increased over the past 2 decades with platinum-based chemotherapy. This report has three objectives: (1) comparison of PVB (cisplatin, vinblastine, and bleomycin) with JEB (carboplatin, etoposide, and bleomycin) regimens; (2) treatment m...

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Main Authors: Jen-Yin Hou, Hsi-Che Liu, Ting-Chi Yeh, Jin-Cherng Sheu, Kuan-Hao Chen, Ching-Yi Chang, Der-Cherng Liang
Format: Article
Language:English
Published: Elsevier 2015-10-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957215000194
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author Jen-Yin Hou
Hsi-Che Liu
Ting-Chi Yeh
Jin-Cherng Sheu
Kuan-Hao Chen
Ching-Yi Chang
Der-Cherng Liang
author_facet Jen-Yin Hou
Hsi-Che Liu
Ting-Chi Yeh
Jin-Cherng Sheu
Kuan-Hao Chen
Ching-Yi Chang
Der-Cherng Liang
author_sort Jen-Yin Hou
collection DOAJ
description The survival of children with malignant germ cell tumor (GCT) increased over the past 2 decades with platinum-based chemotherapy. This report has three objectives: (1) comparison of PVB (cisplatin, vinblastine, and bleomycin) with JEB (carboplatin, etoposide, and bleomycin) regimens; (2) treatment modality of vaginal GCT; and (3) management of stage I testicular yolk sac tumor (YST) in boys under 2 years old. Methods: From January 1, 1987 to December 31, 2010, 81 patients with malignant extracranial GCT were treated. Two consecutive protocols, PVB followed by JEB, were used. Girls with vaginal YST received minimal surgery and chemotherapy. Boys under 2 years old with Stage I testicular YST received surgery with or without chemotherapy. Results: As of June 30, 2012, the 10-year overall survival (OS) was 95 ± 3% (standard error) and the event-free survival (EFS) was 88 ± 4%. With PVB, 35 patients had 10-year OS of 91 ± 5% and EFS of 89 ± 5%. With JEB, 25 patients had 7-year OS of 96 ± 5% and EFS of 96 ± 5%. All five girls with vaginal YST were cured with vagina-preserved strategy. In 32 boys age under 2 years old with stage I YST, 16 with light chemotherapy were all in EFS, whereas two of 16 patients without chemotherapy relapsed. After PVB, six patients developed nephrotoxicity and one had pulmonary fibrosis. Conclusion: Girls with vaginal YST who received minimal surgery and chemotherapy had excellent prognosis and sexual organs were preservable. Light chemotherapy after surgery is a treatment option for boys under 2 years old with stage I YST to decrease relapse rate. Both JEB and PVB are effective. JEB resulted in more myelosuppression but otherwise less serious long-term toxicity than PVB.
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series Pediatrics and Neonatology
spelling doaj-art-d759bb1c1b4544bdab073a1783e1e2ba2025-08-20T02:04:01ZengElsevierPediatrics and Neonatology1875-95722015-10-0156530130610.1016/j.pedneo.2014.12.003Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and TestisJen-Yin Hou0Hsi-Che Liu1Ting-Chi Yeh2Jin-Cherng Sheu3Kuan-Hao Chen4Ching-Yi Chang5Der-Cherng Liang6Mackay Junior College of Medicine, Nursing and Management, Taipei, TaiwanDivision of Pediatric Hematology–Oncology, Mackay Memorial Hospital, Taipei, TaiwanDivision of Pediatric Hematology–Oncology, Mackay Memorial Hospital, Taipei, TaiwanDivision of Pediatric Surgery, Mackay Memorial Hospital, Taipei, TaiwanDivision of Pediatric Hematology–Oncology, Mackay Memorial Hospital, Taipei, TaiwanDivision of Pediatric Hematology–Oncology, Mackay Memorial Hospital, Taipei, TaiwanDivision of Pediatric Hematology–Oncology, Mackay Memorial Hospital, Taipei, TaiwanThe survival of children with malignant germ cell tumor (GCT) increased over the past 2 decades with platinum-based chemotherapy. This report has three objectives: (1) comparison of PVB (cisplatin, vinblastine, and bleomycin) with JEB (carboplatin, etoposide, and bleomycin) regimens; (2) treatment modality of vaginal GCT; and (3) management of stage I testicular yolk sac tumor (YST) in boys under 2 years old. Methods: From January 1, 1987 to December 31, 2010, 81 patients with malignant extracranial GCT were treated. Two consecutive protocols, PVB followed by JEB, were used. Girls with vaginal YST received minimal surgery and chemotherapy. Boys under 2 years old with Stage I testicular YST received surgery with or without chemotherapy. Results: As of June 30, 2012, the 10-year overall survival (OS) was 95 ± 3% (standard error) and the event-free survival (EFS) was 88 ± 4%. With PVB, 35 patients had 10-year OS of 91 ± 5% and EFS of 89 ± 5%. With JEB, 25 patients had 7-year OS of 96 ± 5% and EFS of 96 ± 5%. All five girls with vaginal YST were cured with vagina-preserved strategy. In 32 boys age under 2 years old with stage I YST, 16 with light chemotherapy were all in EFS, whereas two of 16 patients without chemotherapy relapsed. After PVB, six patients developed nephrotoxicity and one had pulmonary fibrosis. Conclusion: Girls with vaginal YST who received minimal surgery and chemotherapy had excellent prognosis and sexual organs were preservable. Light chemotherapy after surgery is a treatment option for boys under 2 years old with stage I YST to decrease relapse rate. Both JEB and PVB are effective. JEB resulted in more myelosuppression but otherwise less serious long-term toxicity than PVB.http://www.sciencedirect.com/science/article/pii/S1875957215000194childhoodgerm cell tumorstage I testes tumorvaginal tumoryolk sac tumor
spellingShingle Jen-Yin Hou
Hsi-Che Liu
Ting-Chi Yeh
Jin-Cherng Sheu
Kuan-Hao Chen
Ching-Yi Chang
Der-Cherng Liang
Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis
Pediatrics and Neonatology
childhood
germ cell tumor
stage I testes tumor
vaginal tumor
yolk sac tumor
title Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis
title_full Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis
title_fullStr Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis
title_full_unstemmed Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis
title_short Treatment Results of Extracranial Malignant Germ Cell Tumor with Regimens of Cisplatin, Vinblastine, Bleomycin or Carboplatin, Etoposide, and Bleomycin with Special Emphasis on the Sites of Vagina and Testis
title_sort treatment results of extracranial malignant germ cell tumor with regimens of cisplatin vinblastine bleomycin or carboplatin etoposide and bleomycin with special emphasis on the sites of vagina and testis
topic childhood
germ cell tumor
stage I testes tumor
vaginal tumor
yolk sac tumor
url http://www.sciencedirect.com/science/article/pii/S1875957215000194
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