The German society of Pediatric Oncology (GPO) designed in 1982 a cooperative study to improve the outlook of patients with malignant testicular germ cell tumors (MAHO 82). So far the combined modality therapy was effective to increase the relapse free survival (Haas et al. 1988). From the data the MAHO 88 protocoll was outlined as follows: Yolk sac tumor: Unilateral orchiectomy; Stage I A - wait and see. Stage I B/C-IV 4 courses standard chemotherapy. If alpha-feto-protein after 2 courses is still positive explorative laparatomy has to be performed. Malignant teratoma (MTI, MTU, MTT), seminoma: Unilateral orchiectomy. Stage I: 4 courses standard chemotherapy. Stage II-IV: 2 courses standard chemotherapy, explorative laparatomy. During explorative laparatomy 3 different approaches are recommended: Modified lymphadenectomy, radical lymphadenectomy or removal of "bulky disease". In case of presence of vital tumor cells patients with teratoma receive "salvage therapy", patients with seminoma receive instead x-irradiation. If only differentiated teratoma cells are found in addition 2 courses of standard chemotherapy are administered. Standard chemotherapy consists of Vinblastine, Bleomycine and Cis-platinum, salvage therapy of VP 16, Ifosfamide and Cis-platinum.

Adolescent↗

PubMedDate not supplied

[Results of the cooperative Malignant Testicular Tumors 82 Study of the German Society of Pediatric Oncology on the therapy of malignant germ cell tumors in childhood].

In the German Society of Pediatric Oncology (GPO) designed in 1982 a cooperative study to improve the outlook of patients with malignant testicular germ cell tumors. According to stage and histology of the tumor different surgical approaches to retroperitoneal lymphadenectomy are outlined. Local radiotherapy is not recommended. Adjuvant chemotherapy with Vinblastine, Bleomycin and CIS-Platinum is proposed. Up to 1987 27 YST, 3 MTI, 6 MTU, 1 MTT and 9 TD were treated. Only one patient with YST had a relapse; one patient died from candida septicemia. Alternative chemotherapy was given 3 times. Overall toxicity from treatment was mild. So far the combined modality therapy was found to be effective to increase the relapse free survival.

Adolescent↗

PubMedDate not supplied

[Chemotherapy of malignant testicular germ cell tumors: current state in children and adults].

Reviewing the literature, it can be conducted that malignant testicular tumors are rare in childhood and can be cured in 80% of cases by orchiectomy alone. Disseminated testicular tumors in children were treated by different combinations of cancer chemotherapy, and in 10 of 24 cases remissions were achieved. Therapeutic recommendations do not exist for childhood. In adults longterm remissions can be attained in the majority of patients with disseminated testicular teratomas by vinblastine and bleomycin alone respectively with additional cisplatinum. Further drugs did not augment the rate of complete or long-term remissions. Combination of vinblastine and bleomycin requires high dosage and a 5 day course of bleomycin. By adding cisplatinum, vinblastine in high dosage (over 0.4 mg/kg) and bleomycin as continuous infusion are no longer necessary. Remission maintenance therapy does not prevent relapses. In patients with relapse ifosfamide and etoposide in combination with cisplatinum frequently are still effective.

Adult↗

PubMedDate not supplied

[Malignant testicular tumors in children and adolescents: concept of the MAHO 82 cooperative therapeutic study of the Society for Pediatric Oncology].

The German Society of Pediatric Oncology (GPO) designed a cooperative study to improve the outlook of patients with malignant (testicular) germ cell tumors. According to stage and histology of the tumor different surgical approaches to retroperitoneal lymphadenectomy are suggested. Local radiotherapy is not recommended. Adjuvant chemotherapy with Vinblastine, Bleomycin and Cis-Platinum according to stage of disease, histologic classification and age of the patient is outlined. For non-responders or patients with only partial response an alternative aggressive chemotherapy with VP 16, Ifosfamide and Cis-Platinum is guidelined.

Adolescent↗

PubMedDate not supplied

[Treatment strategy in non-testicular malignant germ cell tumors in children and adolescents--concept of the MAKEI 83 cooperative therapeutic study of the Society for Pediatric Oncology].

In December 1982 the German Society of Pediatric Oncology (GPO) has initiated a cooperative study for non-testicular malignant germ cell tumors with initial vinblastine, bleomycin and cisplatinum chemotherapy depending on stage and histological grading, followed by ifosfamide, cisplatinum and VP 16 chemotherapy. Dysgerminoma patients with advanced disease are also treated with primary chemotherapy including vinblastine, bleomycin and cisplatinum; radiotherapy is limited to current disease. Patients with more differentiated teratomas receive combination chemotherapy with vinblastine, actinomycin D and cyclophosphamide.

Adolescent↗