[Testicular malignant tumours. Efficacy of germ cell and sex cord tumours treatment protocol in Poland].
Approximately 2% of of all malignant tumours in boys are localised in the testis. Among them 80% are germ cell tumours with the malignant elements of yolk sac tumour. AIM of the study was evaluation of the efficacy of malignant testicular tumour treatment programme in children.


METHODS
Since 1998 31 boys aged 1 month to 18 years (median 14 years) with malignant testicular tumours were enrolled in the multicentre trial. Patomorphologically clear yolk sac tumour (33%) and mixed germ cell tumour (42%) with the majority of yolk sac tumour component or carcinoma embryonale, occurred most often. Alfa-feto-protein was increased in 63% and choriogonadotropin in 26 patients. 61% patients had local clinical stage and the tumour was localized in the testis. In 39% patients tumour exceeded the testis margin. 4 patients were excluded from analysis as 3 are actually treated and 1 died on the second day of admittance to hospital. All patients received TGM 95 regimen (Tumeurs Germinales Malignes). Surgery (orchidectomy) was applied in 27 boys, 26 were primary (81% complete), 3 secondary (100% complete). 33% received no chemotherapy after surgery, in 41% VBP protocol (vinblastine, bleomycin, cisplatin) was given and in 26%o VIP protocol (ethoposide, ifosphamide, cisplatin). Two patients received also ABK (adriamycine, bleomycin, carboplatin).


RESULTS
Among 26 children with germ cell tumours, 25 (96%) are alive, 23 (88%) are in first remission after completion of treatment. One child died due to central nervous system metastases. 2 children had local recurrence treated with chemotherapy or surgery with good result. Median follow-up is 45 months.


CONCLUSIONS
TGM regimen is highly efficient in the treatment of malignant testicular tumours. Problems occur in cases of disseminated disease.
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; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D018240:Endodermal Sinus Tumor / Q000188:drug therapy; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology; D011044:Poland; D012074:Remission Induction; D018312:Sex Cord-Gonadal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology; D013736:Testicular Neoplasms / 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