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Treatment for Advanced Testicular Cancer with High‐Dose Chemotherapy and Autologous Blood Stem Cell Transplantation
Author(s) -
Takahashi Atsushi,
Miyao Noriomi,
Masumori Naoya,
Takeda Kouichi,
Shigyo Masanori,
Sasamura Hiroto,
Sakamaki Sumio,
Niitsu Yoshiro,
Tsukamoto Taiji
Publication year - 1998
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1998.tb00241.x
Subject(s) - medicine , etoposide , chemotherapy , stem cell , carboplatin , surgery , ifosfamide , bone marrow , transplantation , oncology , cisplatin , genetics , biology
Background This study was carried out to investigate the efficacy and safety of high‐dose chemotherapy (HDC) for the treatment of patients with advanced testicular cancer. Methods Seven patients were treated with high‐dose carboplatin, etoposide, and ifosfamide followed by autologous blood stem cell transplantation. One patient received 1 cycle, 4 patients received 2 cycles, and 2 patients received 3 cycles of HDC. We performed a total of 15 autologous blood stem cell transplantations: 8 with autologous bone marrow; 6 with peripheral blood stem cells; and 1 with peripheral blood stem cells in addition to autologous bone marrow. Results Four of the 7 patients achieved a pathologic complete response via early use of HDC and additional salvage surgery. All 4 patients are still alive without evidence of disease at 12, 30, 33, and 54 months, respectively. One patient is alive with active disease at 35 months. Two patients refractory to conventional chemotherapy died of progressive disease at 5 and 27 months, respectively. The hematologic recovery after HDC was rapid, and peripheral blood stem cells tended to have shorter hematologic recovery compared with those from autologous bone marrow, although the difference was not significant. Nonhematologic toxicity was usually mild and manageable. Conclusion High‐dose chemotherapy, followed by autologous blood stem cell transplantation, may be safe and effective for patients with advanced testicular cancer, particularly when early use of HDC is conducted for chemotherapy‐sensitive patients. A further large, long‐term, follow‐up study will be needed to define the role of HDC.