Successful treatment of metastatic extragonadal endodermal sinus (Yolk Sac) tumor in childhood

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Abstract
Two children with metastatic extragonadal endodermal sinus tumor who had failed VAC [vincristine, actinomycin D cyclophosphamide] chemotherapy were treated with combination chemotherapy consisting of cis-platinum, vinblastine, doxorubicin HCl (Adriamycin) and bleomycin (cis-VAB). There was a complete response in both patients with 1 child remaining tumor-free 3 1/2 yr after metastasis and 2 1/2 yr after stopping therapy. The main toxic reactions encountered were associated with the use of cis-platinum but these were manageable and resolved upon completion of therapy. Cis-VAB appears to be a safe and effective regimen for the treatment of metastatic endodermal sinus tumor. A study of the efficacy of cis-VAB in a larger group of children with endodermal sinus tumor of poor prognosis seems indicated.