Lowered Cisplatin Dose and No Bleomycin in the Treatment of Pediatric Germ Cell Tumors: Results of the GCT-99 Protocol From the Brazilian Germ Cell Pediatric Oncology Cooperative Group

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dc.citation.issue6
dc.citation.volume34
dc.contributor.authorLopes, Luiz Fernando
dc.contributor.authorPacheco Donato Macedo, Carla Renata [UNIFESP]
dc.contributor.authorAguiar, Simone dos Santos
dc.contributor.authorBarreto, Jose Henrique S.
dc.contributor.authorMartins, Gisele Eiras
dc.contributor.authorSonaglio, Viviane
dc.contributor.authorMilone, Marcelo
dc.contributor.authorLima, Eduardo Ribeiro
dc.contributor.authorde Assis Almeida, Maria Teresa
dc.contributor.authorAzevedo Allemand Lopes, Paula Maria
dc.contributor.authorWatanabe, Flora Mitie
dc.contributor.authorMello D'Andrea, Maria Lydia
dc.contributor.authorPianovski, Mara Albonei
dc.contributor.authorMelaragno, Renato
dc.contributor.authorRossi Vianna, Sonia Maria
dc.contributor.authorSchultz Moreira, Mauber Eduardo
dc.contributor.authorBruniera, Paula
dc.contributor.authorde Oliveira, Cleyton Zanardo
dc.coverageAlexandria
dc.date.accessioned2020-08-21T17:00:22Z
dc.date.available2020-08-21T17:00:22Z
dc.date.issued2016
dc.description.abstractPurpose We describe the results of a risk-adapted, response-based therapeutic approach from the Brazilian GCT-99 study on germ cell tumors. Patients and Methods From May 1999 to October 2009, 579 participants were enrolled in the Brazilian GCT-99 study. Treatment, defined as specific chemotherapy regimen and number of cycles, was allocated by means of risk-group assignment at diagnosis with consideration for stage and primary tumor site. Patients at low risk received no chemotherapy. Patients at intermediate risk (IR) with a good response (GR) received four cycles of platinum and etoposide (PE), for total doses of platinum 420 mg/m(2) and etoposide 2,040 mg/m(2). Patients at IR with a partial response (PR) received three cycles of PE plus three cycles of ifosfamide, vinblastine, and bleomycin. Patients at high risk (HR) with a GR received four cycles of PE and ifosfamide (PEI) at total doses of platinum 420 mg/m2, etoposide 1,200 mg/m(2), and ifosfamide 30 g/m(2). Patients at HR with a PR received six cycles of PEI. Results The risk-group distribution was 213 LR, 138 IR, and 129 HR for 480 evaluable patients. Overall survival (OS) and event -free survival (EFS) rates at 10 years were, respectively, 90% and 88.6% in the IR-GR group (n = 126) and 74.1% and 74.1% in the IR-PR group (n = 12). Ten-year rates for the HR-GR group (n = 86) were an OS of 66.8% and an EFS of 62.5%. The HR -PR group (n = 43) had an OS of 74.8% and an EFS of 73.4%. In univariable and multivariable analysis, increased serum lactate dehydrogenase level and histology for a metastatic immature teratoma were prognostic of a worsened outcome. Conclusion Reduction of therapy to two drugs did not compromise survival outcomes for patients in the IR-GR group, and escalation of therapy with PEI did not significantly improve OS and EFS in patients at HR. 2016 by American Society of Clinical Oncologyen
dc.description.affiliationBrazilian Soc Pediat Oncol, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Inst Oncol Pediat GRAACC, Sao Paulo, Brazil
dc.description.affiliationHosp AC Camargo Fund Antonio Prudente, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, ITACI FMUSP, Sao Paulo, Brazil
dc.description.affiliationHosp Infantil Darcy Vargas, Sao Paulo, Brazil
dc.description.affiliationHosp Santa Marcelina, Sao Paulo, Brazil
dc.description.affiliationHosp Serv Publ Estadual, Sao Paulo, Brazil
dc.description.affiliationSanta Casa de Misericordia Sao Paulo, Sao Paulo, Brazil
dc.description.affiliationHosp Canc Infanto Juvenil Barretos, Ave Joao Baroni 3025, BR-14784390 Barretos, SP, Brazil
dc.description.affiliationHosp Canc Barretos, Barretos, Brazil
dc.description.affiliationCentro Infantil Boldrini, Campinas, SP, Brazil
dc.description.affiliationCIPED FCM Unicamp, Campinas, SP, Brazil
dc.description.affiliationCtr Tratamento Fabiana Macedo de Morais GACC, Sao Jose Dos Campos, Brazil
dc.description.affiliationHosp Sao Rafael ONCO Bahia, Salvador, BA, Brazil
dc.description.affiliationHosp Baleia, Belo Horizonte, MG, Brazil
dc.description.affiliationHosp Crianca Brasilia Jose Alencar, Brasilia, DF, Brazil
dc.description.affiliationHosp Infantil Pequeno Principe, Curitiba, Parana, Brazil
dc.description.affiliationHosp Erasto Gaertner, Curitiba, Parana, Brazil
dc.description.affiliationHosp Univ Santa Maria, Santa Maria, RS, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Inst Oncol Pediat GRAACC, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent603-+
dc.identifierhttp://dx.doi.org/10.1200/JCO.2014.59.1420
dc.identifier.citationJournal Of Clinical Oncology. Alexandria, v. 34, n. 6, p. 603-+, 2016.
dc.identifier.doi10.1200/JCO.2014.59.1420
dc.identifier.issn0732-183X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57965
dc.identifier.wosWOS:000374332900018
dc.language.isoeng
dc.publisherAmer Soc Clinical Oncology
dc.relation.ispartofJournal Of Clinical Oncology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleLowered Cisplatin Dose and No Bleomycin in the Treatment of Pediatric Germ Cell Tumors: Results of the GCT-99 Protocol From the Brazilian Germ Cell Pediatric Oncology Cooperative Groupen
dc.typeinfo:eu-repo/semantics/article
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