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Hematological Oncology 1993
Clinical Trial
Topics: Age Factors; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Combined Modality Therapy; Cyclophosphamide; Etoposide; Hodgkin Disease; Humans; Middle Aged; Prednisone; Registries; Retrospective Studies; Vincristine
PubMed: 7683625
DOI: No ID Found -
Medical and Pediatric Oncology 1993Familial germ cell tumours are well recognised in kinship with gonadal dysgenesis, but their occurrence in siblings with normal chromosomes is rare. We report two...
Familial germ cell tumours are well recognised in kinship with gonadal dysgenesis, but their occurrence in siblings with normal chromosomes is rare. We report two sisters who presented within a 4 month period with malignant ovarian germ cell tumours; one a dysgerminoma and the other a mixed tumour with marked choriocarcinomatous elements. Both children had a normal female constitutional karyotype and normal phenotype.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Chemotherapy, Adjuvant; Child; Choriocarcinoma; Dysgerminoma; Etoposide; Female; Humans; Neoplasms, Germ Cell and Embryonal; Nuclear Family; Ovarian Neoplasms
PubMed: 7682284
DOI: 10.1002/mpo.2950210413 -
Journal of Clinical Oncology : Official... Jan 1991The combination of carboplatin, etoposide, and bleomycin (CEB) was evaluated as initial chemotherapy in 76 patients with good-prognosis metastatic nonseminomatous germ... (Clinical Trial)
Clinical Trial
The combination of carboplatin, etoposide, and bleomycin (CEB) was evaluated as initial chemotherapy in 76 patients with good-prognosis metastatic nonseminomatous germ cell tumors (NSGCT) between 1984 and 1988. The classification of eligible patients included Royal Marsden Hospital (RMH) stages IM, IIA, IIB, IIC, IIIA, IIIB, IV0ABCL1, and IV0ABL2. Four courses of combination chemotherapy were administered in a 21-day cycle, and surgical excision of residual mass was performed in 27 cases (23 laparotomies and four thoracotomies). At the time of analysis, median follow-up was 24 months from start of chemotherapy (range, 6 to 54 months). The 2-year cause-specific survival probability was 98.5%, the single cause-related mortality being caused by bleomycin pneumonitis. Five patients failed CEB chemotherapy, but all have been successfully salvaged with a combination of surgery and intensive chemotherapy, follow-up from completion of all treatment being 35 to 44 months. The toxicity of CEB included bone marrow suppression and alopecia in all patients but no significant neurotoxicity or ototoxicity, and minimal renal toxicity. Only four (5%) patients had a decrease in the glomerular filtration rate greater than 15%. In 51% of patients, the hemoglobin fell below 10 g/dL. The WBC count nadir was less than 1,500/microL in 11% of treatment cycles and in 16% the platelet nadir fell below 50,000/microL. Decreases in the WBC and platelet counts were of very brief duration. Only one of 310 CEB cycles was complicated by neutropenic sepsis, and there were no episodes of thrombocytopenic purpura or bleeding. We conclude that the CEB combination represents an effective alternative to cisplatin-based chemotherapy in good-prognosis NSGCT and that the replacement of cisplatin by carboplatin leads to reduced toxicity.
Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Child; Etoposide; Follow-Up Studies; Glomerular Filtration Rate; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal; Remission Induction; Sperm Count; Survival Rate; Testicular Neoplasms
PubMed: 1702147
DOI: 10.1200/JCO.1991.9.1.62 -
British Journal of Cancer Aug 1990Between February 1986 and July 1988 a total of 21 children aged 1 to 16 years with malignant germ cell tumours (MGCT), 18 with either metastatic disease or unresectable...
Between February 1986 and July 1988 a total of 21 children aged 1 to 16 years with malignant germ cell tumours (MGCT), 18 with either metastatic disease or unresectable primary tumour, received the JEB regimen - carboplatin dosage calculated from the EDTA glomerular filtration rate (approximately 600 mg m-2), etoposide 120 mg m-2 daily x 3, and bleomycin 15 mg m-2 weekly. Primary sites were: testis (6), ovary (8), sacrococcyx (4), pineal gland (2) and vagina (1). AFP levels were elevated in 19, beta-HCG in 8. Complete marker response was achieved in 19 out of 19 evaluable patients and complete remission of measurable tumour in 16 out of 19, 12 with chemotherapy alone and 4 with the addition of surgery. A reduction in glomerular filtration rate greater than 10% occurred in 3 of 12 evaluable patients; in none greater than 20%. Sequential audiography was normal in 11 out of 12 evaluated. The regimen was myelosuppressive with WHO grade III or IV myelosuppression occurring in 12 patients. Three patients have relapsed; one with a pineal germinoma who relapsed in the abdomen six months after diagnosis, and two with sacrococcygeal teratomas and lung metastases. Two of these remain in second complete remission after further treatment. There was one death from probable bleomycin pulmonary toxicity. We conclude that this regimen is simple to administer and, apart from myelosuppression, it is well tolerated. It appears to have comparable efficacy to cisplatin-based regimens but with much less nephrotoxicity and ototoxicity and avoids the use of alkylating agents and anthracyclines.
Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Child; Child, Preschool; Etoposide; Female; Humans; Infant; Lung; Male; Neoplasms, Germ Cell and Embryonal; Organoplatinum Compounds
PubMed: 1696831
DOI: 10.1038/bjc.1990.272