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Pediatric germ cell tumor. An experience with BEP
G Kapoor1, S H Advani, C N Nair
1Department of Medical Oncology, Tata Memorial Hospital, Bombay, India.
Insights
Bleomycin, etoposide, and cisplatin (BEP) chemotherapy is highly effective for treating pediatric germ cell tumors (GCTs). This treatment regimen demonstrates excellent tolerability and high survival rates in young patients.
Area of Science:
- Pediatric Oncology
- Medical Chemotherapy
- Germ Cell Tumors
Background:
- Pediatric germ cell tumors (GCTs) represent a significant challenge in pediatric oncology.
- Effective and well-tolerated treatment regimens are crucial for improving outcomes in children with GCTs.
Purpose of the Study:
- To analyze the clinical experience with bleomycin, etoposide, and cisplatin (BEP) chemotherapy for pediatric GCTs.
- To evaluate the efficacy and toxicity of BEP chemotherapy in this patient population.
Main Methods:
- Retrospective analysis of pediatric patients (<16 years) diagnosed with GCT between May 1988 and May 1993.
- Patients received bleomycin, etoposide, and cisplatin (BEP) chemotherapy.
- Analysis included clinicopathological features, response rates, survival, and toxicity.
Main Results:
- A total of 56 pediatric patients were included, with ovarian, testicular, and extragonadal GCTs represented.
- Complete response rates were 89.1%, with 5-year actuarial survival at 83% and progression-free survival at 93%.
- BEP chemotherapy was well tolerated with minimal toxicity.
Conclusions:
- BEP chemotherapy is a highly effective and well-tolerated treatment for pediatric germ cell tumors.
- Combining conservative surgery with effective chemotherapy, such as BEP, offers a promising approach for curative treatment in most children with GCTs.
Purpose:
This study is an analysis of our experience with bleomycin, etoposide, and cisplatin (BEP) chemotherapy, in pediatric germ cell tumors (GCTs).
Patients And Methods:
The study included all children (age < 16 years) who were registered between May 1988 and May 1993 with a histologically 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 testicular or an extragonadal tumor. Histologically, endodermal sinus tumor 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 partial responses in 10.9% (6 of 55) of the evaluable patients. Five-year actuarial survival was 83% and progression free survival was 93%. Median 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 tolerated in children with GCT. The data probably suggests that conservative surgery, when combined with effective chemotherapy, can result in cure of the majority of children with GCTs.