title: Treatment of children and adolescents with stage II testicular and stages I and II ovarian malignant germ cell tumors: A Pediatric Intergroup Study--Pediatric Oncology Group 9048 and Children's Cancer Group 8891.
abstract: OBJECTIVE
  To determine whether children with localized gonadal malignant germ cell tumors (MGCT) stage II testicular and stages I and II ovarian treated with four cycles of standard-dose cisplatin combined with etoposide and low-dose bleomycin (PEB) have an event-free survival (EFS) of at least 85% without significant toxicity.
  
  
  METHODS
  Between May 1990 and July 1995, eligible pediatric patients with stage II or recurrent from stage I (as a stage II) testicular MGCT and stages I and II ovarian MGCT were enrolled onto this Pediatric Oncology Group and Children's Cancer Group study. PEB chemotherapy consisted of bleomycin 15 U/m2 on day 1, cisplatin 20 mg/m2/d on days 1 to 5, and etoposide 100 mg/m2/d on days 1 to 5. Patients received four cycles of therapy at 21-day intervals.
  
  
  RESULTS
  Seventy-four patients with a median age of 10.5 years (range, 8.7 months to 16.7 years) were enrolled. Primary sites included: stage II testicular (n = 17), stage I ovarian (n = 41), and stage II ovarian MGCT (n = 16). Treatment with standard PEB resulted in 6-year EFS of 95% and overall survival (OS) of 95.7%. EFS and OS by primary site were as follows: stage II testicular, 100% and 100%; stage I ovarian, 95.1% and 95.1%; and stage II ovarian, 87.5% and 93.8%, respectively. Two patients died from recurrent disease, and one patient died of secondary acute myelocytic leukemia. Infrequent grade 3 to 4 hematologic toxicity was reported. No grade 3 to 4 renal, pulmonary, or ototoxicity was observed.
  
  
  CONCLUSIONS
  Combination chemotherapy with PEB results in excellent EFS and OS with minimal toxicity in children and adolescents with localized gonadal MGCT.
authors.affiliation: British Columbia Children's Hospital, Vancouver, Canada.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Rogers
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Olson
authors.forename: John W
authors.initials: JW
authors.lastname: Cullen
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Billmire
authors.forename: Neyssa
authors.initials: N
authors.lastname: Marina
authors.forename: Frederick
authors.initials: F
authors.lastname: Rescorla
authors.forename: Mary M
authors.initials: MM
authors.lastname: Davis
authors.forename: Wendy B
authors.initials: WB
authors.lastname: London
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lauer
authors.forename: Roger H
authors.initials: RH
authors.lastname: Giller
authors.forename: Barbara
authors.initials: B
authors.lastname: Cushing
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008297:Male; D009503:Neutropenia; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000601:surgery
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin