Effect of Preoperative Chemotherapy on Malignant Extragonadal Germinoma in Children / 实用儿科临床杂志

ABSTRACT

Objective To explore the effect of preoperative chemotherapy for children with malignant extragonadial germinoma. Methods Twenty patients with malignant extrogonadal germinoma had been treated with preoperative chemotherapy from Mar.2003 to Mar.2007.Protocol 1 of chemotherapy was to improve PEB(cisplatin plus etoposide plus bleomycin A5);Protocol 2 was VAC(vincristine plus actinomycin D plus cyclophosphamide) the average time span of the chemotherapy was 16 weeks.Upon completion of chemotherapy,tumor resection was performed.The content of alpha fetoprotein(AFP) was determined before operation and compared with the content before chemotherapy.Re-gular follow-up procedure was taken after operation. Results All 20 patients received chemotherapy and underwent operation.The removal rate of resection operation was 100%,the process of operation was smooth.The volume of tumors in 14 patients decreased over 50% compared with those before chemotherapy.The response rate was 70%.The content of AFP decreased significantly in 15 patients(75%).Fifteen patients had been living without tumor for up to 2 years,for 5 cases the survival time went beyond 5 years. Conclusions Malignant extrogonadal ger-minoma in children grow infiltratively,bring detrimental effects to neighboring organs,and bring obstacles to resection operation.Chemotherapy for children with malignant extragonadal germinoma before operation can reduce volume of tumor and bleeding during operation,raise the resectability rate and lower the content of AFP.It will enhance the effectiveness of operation and improve prognosis.Therefore,it can be used as a conventional clinical method.