Outcome and reproductive function after cumulative high-dose combination chemotherapy with bleomycin, etoposide and cisplatin (BEP) for patients with ovarian endodermal sinus tumor.
OBJECTIVE
The aim of this study was to investigate the outcome and reproductive function of patients with ovarian endodermal sinus tumor (EST) after cumulative high-dose combination chemotherapy with bleomycin, etoposide and cisplatin (BEP).


METHODS
Between 1995 and 2006, 1034 patients with the diagnosis of ovarian cancer were treated at a single institution. Among these patients, 51 had a confirmed diagnosis of malignant ovarian germ cell tumor (MOGCT) including 20 cases of EST. We retrospectively reviewed those patients with EST, who received BEP as adjuvant chemotherapy. The doses were 15 mg/day of bleomycin on days 1 to 3, 100 mg/m(2)/day IV of etoposide on days 1 to 3 and 20 mg/m(2)/day of cisplatin on days 1 to 5. The median number of total cycles was six (range between three and nine).


RESULTS
The median age of the patients with EST was 18 years (range 5 to 36). All except two were nulliparous. The overall survival rate was 90% at a median follow-up of 70 months. Two patients (10%) had disease recurrence in the pelvis. Of the 15 patients who were treated with fertility-sparing surgery, all had regular menstruation following the completion of adjuvant chemotherapy, and two of these patients had pregnancies with live birth deliveries and no complications.


CONCLUSIONS
In patients with EST, the cumulative high-dose BEP regimen resulted in excellent overall survival and did not seem to impair ovarian function.
Kang
Heeseok
H
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kim
Tae-Joong
TJ
Kim
Woo Young
WY
Choi
Chel Hun
CH
Lee
Jeong-Won
JW
Kim
Byoung-Gie
BG
Bae
Duk-Soo
DS
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D018240:Endodermal Sinus Tumor / Q000188:drug therapy* / Q000503:physiopathology* / Q000601:surgery; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000503:physiopathology* / Q000601:surgery; D010053:Ovary / Q000503:physiopathology*; D012189:Retrospective Studies; D016896:Treatment Outcome
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin