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Indian Journal of Medical and Paediatric Oncology
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Year : 1995  |  Volume : 16  |  Issue : 2  |  Page : 81-88

Chemotherapy in malignant germ cell tumors of ovary.


Dept of Medical Oncology, Gynaecology and Pathology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
L Kumar
Dept of Medical Oncology, Gynaecology and Pathology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

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Source of Support: None, Conflict of Interest: None


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Purpose: to evaluate the efficacy of cisplatin based combination chemotherapy in patients with germ cell tumors of ovary. Design: Prospoective, nonrandomized study with end points of tumor response, overall and disease-free survival. Setting: Single Institution based experience. Patients and Methods: Thirty three patients had received chemotherapy for recurrent disease. Histology subtypes were: dysgerminoma-13, immature teratoma-10, endodermal sinus tumor-6, mixed germ cell tumor-3 and choriocarcinoma in one patient. FIGO staging revealed:Stage 1-8,11-3, 111-17 and stage IV in 5 patients. 28 patients received 4 cycles of chemotherapy(PVB, n=19, BEP,n=9) and 5 patients with nonmeasurable disease received 3 cycles of BEP as adjuvant. Results: Overall, 27(82 percent) patients responded; complete(CR)-24(72.7 percent) and partial in 3 patients. Four patients had progressive disease. Two of four patients with recurrent disease achieved CR. The toxicity to PVB was moderate; one patient died due to PVB toxicity. Three patients with CR relapsed, 2 after 4 months and one after 16 months. Two of these 3 patients achieved second CR with alternate chemotherapy and one died of progressive disease. Nine patients were evaluated with second look laparotomy, n=7 or laparoscopy, n=2. The findings were negative in 7, mature teratoma in one and one patient had fibrrotic mass. 16 of 24 completer in 7, mature teratoma in one and one patient had fibrotic mass. 16 of 24 complete responders had preservation of contralateral ovary and uterus. Of these 13 had resumed normal menstruation. Functional ovarian cystt was seen in 4 patients. Three patients who attempted pregnancy, succeded in it; two delivered normal full term babies, another aborted after three months. The Kaplan and meter estimate of cumulative and disease-free survival at 78 months is 66.6 percent +9.1(SD) and 66.6 percent +8.5(SD) respectively. Currently,22 of 33 patients are alive and disease-free. 10 of 13 patientswith dysgerminoma are disease-free. Conclusions: Cisplatin based chemotherapy is effective in the treatment of germ cell tumors of ovary. It is suggested that 4 cycles of chemotherapy delivered over brief period may be adequate and treatment for longer period may not be necessary. The BEP combination is less toxic compared to PVB.


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