[Ovarian malignant tumours. Efficacy of germ cell and sex cord tumour treatment protocol in Poland].
Approximately 1% of all malignant tumours among children are localized in the ovary. The majority belongs to germ cell tumours and occurs in the peripubertal period. AIM of the study was the evaluation of the efficacy of malignant ovarian germ cell tumour treatment programme in children.


METHODS
Since 1998, 40 girls with malignant ovarian tumours were enrolled in the multicentre trial. Mixed germ cell tumours with yolk sac elements and dysgerminoma occurred the most often. Alfa-fetoprotein (AFP) was increased in almost one half of patients. Tumour exceeded the ovary margin in more than half the patients and 25% were qualified as high risk group. 38 children completed the treatment. All but one patient with neuroblastoma received TGM protocol (Tumeurs Germinates Malignes). A VBP regimen (vinblastine, bleomycin, cisplatin) was applied in 19 girls, VIP regimen (etoposide, ifosfamide, cisplatin) in 16, two received no chemotherapy. Due to delayed remission after first-line chemotherapy it was prolonged with ABK (adriamycine, bleomycine, carboplatin) in 3 patients, 1 megachemotherapy regimen with autologous bone marrow transplantation was realized, one patient received a 1.5 year long oral chemotherapy. All the children underwent surgery, 34 primary (56% complete), 12 secondary (75% complete). 8 children were operated twice.


RESULTS
Among 34 children with germ cell tumours and 3 with sex cord tumours who completed the treatment all are alive in the first remission. 1 child with neuroblastoma localised in the ovary died due to recurrence. A median follow-up period was 42 months.


CONCLUSIONS
The TGM protocol appears to be highly efficient in treatment of germ cell tumours even in advanced stages.
Popadiuk
Stefan
S
Klinika Pediatrii, Gastroenterologii i Onkologii Dzieciecej, Akademia Medyczna, ul. Nowe Ogrody 1-6, 80-803 Gdańsk, Poland. step@amg.gda.pl
Korzon
Maria
M
Chybicka
Alicja
A
Szmyd
Krzysztof
K
Dzierzega
Maria
M
Trelińska
Joanna
J
Kowalczyk
Jerzy R
JR
Wiśniewska-Slusarz
Hanna
H
Woźniak
Wojciech
W
Bilska
Katarzyna
K
Wachowiak
Jacek
J
Konatkowska
Benigna
B
Wysocki
Mariusz
M
Krawczuk-Rybak
Maryna
M
Czauderna
Piotr
P
Szumera
Małgorzata
M
Sznurkowska
Katarzyna
K
Renke
Joanna
J
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011044:Poland; D012074:Remission Induction; D018312:Sex Cord-Gonadal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D016190:Carboplatin; D002945:Cisplatin; D007069:Ifosfamide