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In order to assess the importance of the intensity of administration of chemotherapy in the management of advanced germ cell tumours we have calculated indices of chemotherapy. These have been used to compare the treatment given to patients who subsequently relapsed with matched controls who did not relapse. Two of these indices (alpha and beta) are derived from the doses of drugs whose dose is varied (cisplatinum, methotrexate and etoposide). These indices showed significant variation between cases and controls. Indices gamma and delta are derived from drugs whose dose is not varied. They showed no significant differences between the two groups. These results emphasise the importance of ensuring that patients with these curable cancers receive adequate doses of chemotherapy.

The effect of intensity of administered treatment on the outcome of germ cell tumours treated with POMB/ACE chemotherapy