MALIGNANT GERM-CELL TUMORS IN CHILDHOOD

The outlook for patients with germ cell tumors was poor before the adv ent of effective chemotherapy. In this study the outcome of multiagent chemotherapy in children treated for germ cell tumor is assessed. Bet ween January 1984 and December 1990, 107 patients were diagnosed to ha ve germ cell tumors. Postsurgical therapy was based on tumor site, sta ge, and histology. Combination chemotherapy was employed in patients w ith Stages I and II disease with postoperative raised tumor markers an d all patients with Stages III and IV. Between 1984-1988, patients rec eived cisplatin, vinblastin, bleomycin, and methotrexate (PVB-M), and thereafter between 1988-1990, they received bleomycin, etoposide, and cisplatin (BEP). Of 34 patients treated with PVB-M and 27 treated with BEP, the complete remission rate was 40% and 85%, respectively, and t he overall survival was 30% at 5 years for PVB-M and 80% at 3 years fo r BEP. We conclude that etoposide with cisplatin is superior to vinbla stin with cisplatin in the treatment of advanced germ cell tumors beca use of greater efficacy, decreased toxicity, and better compliance in children. (C) 1994 Wiley-Liss, Inc.