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Medline ® Abstract for Reference 50

of 'Treatment of malignant germ cell tumors of the ovary'

Cisplatin and etoposide in childhood germ cell tumor: brazilian pediatric oncology society protocol GCT-91.
Lopes LF, Macedo CR, Pontes EM, Dos Santos Aguiar S, Mastellaro MJ, Melaragno R, Vianna SM, Lopes PA, Mendonça N, de Assis Almeida MT, Sonaglio V, Ribeiro KB, Santana VM, Schneider DT, de Camargo B
J Clin Oncol. 2009;27(8):1297. Epub 2009 Jan 21.
PURPOSE: In 1988, we formed a consortium of Brazilian institutions to develop uniform standards for the diagnostic assessment and multidisciplinary treatment of children and adolescents with germ cell tumors. We also implemented the first childhood Brazilian germ cell tumor protocol, GCT-91, evaluating two-agent chemotherapy with cisplatin and etoposide (PE). We now report on the clinical characteristics and survival of children and adolescents with germ cell tumors treated on this protocol.
PATIENTS AND METHODS: From May 1991 to April 2000, 115 patients (106 assessable patients) were enrolled onto the Brazilian protocol with a diagnosis of germ cell tumor.
RESULTS: Patients were treated with surgery only (n = 35) and chemotherapy (n = 71). Important prognostic factors included stage (P = .025), surgical procedure at diagnosis according to resectability (P<.032), andabnormal lactate dehydrogenase value at diagnosis (P<.001).
CONCLUSION: The improvement in survival by the introduction of a standard protocol is an important achievement. This is of particular importance for smaller institutions with previous limited experience in the treatment of childhood germ cell tumors. In addition, the results of a two-agent regimen with PE were favorable (5-year overall survival rate is 83.3% for patients in the high-risk group [n = 36]who received PE v 58.8% for patients in the high-risk patients group who received PE plus ifosfamide, vinblastine, and bleomycin [n = 17; P = .017]). Thus for selected patients, complex three-agent regimens may not be necessary to achieve long-term survival, even for some patients with advanced disease.
Brazilian Germ Cell TumourStudy Group of the Sociedade Brasileira de Oncologia Pediátrica, Av Moema, 94 cj 31, Cep 04077-020 São Paulo-SP, Brasil. lf.lopes@yahoo.com