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Title: Cisplatin and Etoposide in Childhood Germ Cell Tumor: Brazilian Pediatric Oncology Society Protocol GCT-91
Authors: Lopes, Luiz Fernando
Pacheco Macedo, Carla Renata
Pontes, Elitania Marinho
Aguiar, Simone dos Santos
Mastellaro, Maria Jose
Melaragno, Renato
Vianna, Sonia Maria Rossi
Allemand Lopes, Paula Azevedo
Mendonca, Nubia
Assis Almeida, Maria Teresa de
Sonaglio, Viviane
Ribeiro, Karina B.
Santana, Victor M.
Schneider, Dominik T.
Camargo, Beatriz de
Ctr Tratamento & Pesquisa Hosp Canc
Universidade Federal de São Paulo (UNIFESP)
Hosp Santa Marcelina
Hosp Servidor Publ Estadual
Universidade de São Paulo (USP)
Ctr Infantil Boldrini
Hosp Base Dist Fed
Clin Onco
St Jude Childrens Hosp
Pediat Clin
Issue Date: 10-Mar-2009
Publisher: Amer Soc Clinical Oncology
Citation: Journal of Clinical Oncology. Alexandria: Amer Soc Clinical Oncology, v. 27, n. 8, p. 1297-1303, 2009.
Abstract: PurposeIn 1988, we formed a consortium of Brazilian institutions to develop uniform standards for the diagnostic assessment and multidisciplinary treatment of children and adolescents with germ cell tumors. We also implemented the first childhood Brazilian germ cell tumor protocol, GCT-91, evaluating two-agent chemotherapy with cisplatin and etoposide (PE). We now report on the clinical characteristics and survival of children and adolescents with germ cell tumors treated on this protocol.Patients and MethodsFrom May 1991 to April 2000, 115 patients (106 assessable patients) were enrolled onto the Brazilian protocol with a diagnosis of germ cell tumor.ResultsPatients were treated with surgery only (n = 35) and chemotherapy (n = 71). Important prognostic factors included stage (P = .025), surgical procedure at diagnosis according to resectability (P = .032), and abnormal lactate dehydrogenase value at diagnosis (P = .001).ConclusionThe improvement in survival by the introduction of a standard protocol is an important achievement. This is of particular importance for smaller institutions with previous limited experience in the treatment of childhood germ cell tumors. in addition, the results of a two-agent regimen with PE were favorable (5-year overall survival rate is 83.3% for patients in the high-risk group [n = 36] who received PE v 58.8% for patients in the high-risk patients group who received PE plus ifosfamide, vinblastine, and bleomycin [n = 17; P = .017]). Thus for selected patients, complex three-agent regimens may not be necessary to achieve long-term survival, even for some patients with advanced disease.
ISSN: 0732-183X
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