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Thursday, 11 July 2013

Regional deep hyperthermia could be a treatment for children and adolescents with refractory or recurrent non-testicular malignant germ-cell tumours

Medical researchers at the Paediatric Oncology Clinic, Haematology and Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich- Heine-University Düsseldorf, Düsseldorf, Germany have recently published findings about a study involving 44 patients, aged 7 months to 21 years, where regional deep hypothermia was successfully used to treat malignant germ cell tumours.

In recent years, the survival of children and adolescents with malignant germ-cell tumours has improved substantially. However, the outcome remains poor for patients with refractory or recurrent malignant germ-cell tumours. The Düsseldorf researchers could show that PEI-regional deep hyperthermia can achieve objective tumour response in a study that followed the patients over more than 7 years after treatment. (The median follow-up of surviving patients was 82 months (range 9—195)).

“Of the 35 patients who had sufficient clinical and radiographical data available for response assessment, 30 (86%) had an objective response to treatment (16 patients had complete remission and 14 had partial remission).” However, granulocytopenic fever, which required intercurrent hospital admission, was noted in 29 (66%) of 44 patients and five patients experienced treatment-related grade-3 acute renal toxic effects.

Nevertheless, researchers conclude: “A multimodal strategy integrating PEI-regional deep hyperthermia and tumour resection with or without radiation can successfully treat children and adolescents with refractory or recurrent malignant non-testicular germ-cell tumours. The long-term prognosis of patients with poor response or after first relapse was almost similar to those receiving first-line treatment. This strategy merits further investigation.”

Obviously, this treatment is still in a study phase and not available as standard treatment. But the results are promising and show the high level of expertise regarding child oncology at this big university hospital. German Hospital Service will be happy to assist international patients if they need treatment in Germany for such severe conditions.

The Lancet. July 1, 2013
Dr Rüdiger Wessalowski MD , Prof Dominik T. Schneider MD et al