Treatment Overview If complete resection looks possible at diagnosis, it is attempted. If surgery does not look possible, a biopsy may be done to make the diagnosis and then preoperative chemotherapy may be used to shrink the tumor . In some centers, an initial attempt to surgically resect the tumor is always made.
Surgery, radiation and chemotherapy are combined in the treatment of this diverse tumor. The order in which they are given, which combination of drugs is used and how and how much radiation is delivered vary according to the location, tissue type and extent of the disease. Putting together the many variables about each tumor—staging—allows a specific treatment plan and the most accurate estimate about outcome to be formulated.
Treatment by Group
Group I
No evidence of tumor remaining after surgery.
Standard Treatment Surgery, followed by chemotherapy and, possibly, radiation. The tumors with the best outlook are those around the eye or testes that can be completely removed and have no evidence of spread. Patients are given vincristine and actinomycin, sometimes without radiation therapy .
The next best outlook is for tumors in the head, neck and pelvic areas, other than the bladder and prostate, that can be completely removed. Vincristine or actinomycin or both may be given with cyclophosphamide , etoposide or ifosfamide and radiation.
