Cisplatin, vinblastine and bleomycin in advanced and relapsed germ cell tumours of ovary

Seventeen patients with germ cell tumours of ovary were treated with 4 cycles of cisplatin, bleomycin and vinblastine (PVB) chemotherapy (CT). All patients had undergone prior surgery: hysterectomy + bilateral salpingo-oophorectomy + omentectomy-5, salpingo-oophorectomy + debulking surgery-10 and biopsy alone in 2 patients. Four of seventeen patients had relapsed earlier and received PVB as second line therapy. FIGO staging revealed: stage IIB in one, III C in 12 and stage IV in 4 patients. Gross residual disease (> 2 cm) was present in 13 patients. The most common cell types were dysgerminoma-5, endodermal sinus tumour-5, immature teratoma-5, choriocarcinoma and mixed germ cell tumour in one patient each. Twelve patients (70.5%) achieved significant response; complete response-11, partial response in one patient. The common side effects of CT were nausea/vomiting, myelosuppression, fever, mucositis, diarrhoea and alopecia. One patient died due to CT toxicity. Three complete responders underwent second look surgery and were found free of disease. This study confirms that PVB is an effective combination in the treatment of advanced and recurrent germ cell tumours of ovary and can be given over brief period. The toxicity of the regimen is moderate.