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Salvage high‐dose chemotherapy in patients with germ cell tumors
Author(s) -
Rosti Giovanni,
De Giorgi Ugo,
Salvioni Roberto,
Papiani Giorgio,
Sebastiani Loretta,
Argnani Marzia,
Monti Giuseppe,
Ferrante Patrizia,
Pizzocaro Giorgio,
Marangolo Maurizio
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10672
Subject(s) - medicine , salvage therapy , germ cell tumors , chemotherapy , oncology , surgery , disease
BACKGROUND High‐dose chemotherapy (HDCT) followed by hematopoietic stem cell support (HSCS) potentially may be curative in patients with germ cell tumor (GCT) who develop recurrent tumors or who have an inadequate response after receiving standard‐dose chemotherapy. The authors report their experience with HDCT as salvage therapy for patients with GCT. METHODS Between 1986 and 2000, 84 patients with GCT, with a median age 29 years (range, 15–50 years), were treated with 105 courses of HDCT with HSCS. Patients were stratified into good, intermediate, and poor risk categories according to a validated prognostic index. RESULTS Overall, 28 patients (33%) have been continuously disease free. In the good risk group, 24 patients (69%) have been continuously disease free compared with 4 patients (13%) in the intermediate risk group ( P < 0.001) and 0 patients in the poor risk group ( P < 0.001). Treatment‐related mortality occurred only among patients in the poor risk ( n = 6 patients) and the intermediate risk groups ( n = 4 patients). CONCLUSIONS In the authors' experience, HDCT induced impressive long‐term remissions as salvage treatment among patients in the good risk group. Moreover, the use of validated prognostic classifications may contribute to a better definition of the role of HDCT other than improving the outcome of patients with GCT. The definitive statement on the possible role of HDCT in patients with GCT will derive from the ongoing Phase III randomized studies. Cancer 2002;95:309–15. © 2002 American Cancer Society. DOI 10.1002/cncr.10672