PEDIATRIC GERM-CELL TUMOR - AN EXPERIENCE WITH BEP

Purpose: This study is an analysis of our experience with bleomycin, e toposide, and cisplaiin (BEP) chemotherapy, in pediatric germ cell tum ors (GCTs). Patients and Methods: The study included all children (age <16 years) who were registered between May 1988 and May 1993 with a h istologically confirmed diagnosis of GCT and received BEP chemotherapy . In addition to the clinicopathological features, the response rate, survival rate, and toxicity were analyzed. Results: There was a total of 56 patients, of whom 22 had an ovarian tumor and 17 each had a test icular or an extragonadal tumor. Histologically, endodermal sinus tumo r was the most common type (62%). Tumor markers were increased in 89% (50 of 56). Complete responses were observed in 89.1% (49 of 55) and p artial responses in 10.9% (6 of 55) of the evaluable patients. Five-ye ar actuarial survival was 83% and progression free survival was 93%. M edian follow-up was 18 months. Median survival is not yet reached. The chemotherapy was well tolerated. Conclusions: From the present report , it is apparent that BEP chemotherapy is very effective and well tole rated in children with GCT. The data probably suggests that conservati ve surgery, when combined with effective chemotherapy, can result in c ure of the majority of children with GCTs.