Malignant ovarian germ cell tumors (MOGCTs) mainly affect adolescents and young women and are highly curable with bleomycin, etoposide, and cisplatin (BEP). To reduce toxicity associated with the standard 5-day regimen, we evaluated the efficacy, safety, and fertility outcomes of a 3-day modified BEP regimen in patients with MOGCTs. We conducted a retrospective analysis of 81 MOGCT patients with 3-day modified BEP at the Women’s Hospital, Zhejiang University School of Medicine from 2004 to 2024. The 3-day modified BEP regimen comprised bleomycin (15 U) and etoposide (100 mg/m 2 ) on days 1–3, and cisplatin (75 mg/m 2 ) on day 1, repeated every 4 weeks for 3–6 cycles. All 81 MOGCT patients included in our study underwent primary surgery before chemotherapy; 86.4% had early-stage disease, and fertility-sparing surgery was performed in 73 cases. After a median follow-up of over 9 years, the 5-year progression-free survival rate was 97.5% (95% CI: 94.2–100), with no treatment-related deaths. Bleomycin-induced pneumonitis occurred in 4.9% and resolved with supportive care. Among 30 patients attempting conception, 90% achieved pregnancy, resulting in 25 term live births. The 3-day modified BEP regimen provides excellent survival with reduced toxicity, offering greater convenience and preserved fertility, supporting its use as a safer and more practical treatment alternative for initial chemotherapy in MOGCTs.
Zhang et al. (Wed,) studied this question.
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