Abstract | OBJECTIVE: To review the long-term outcome of patients with recurrent and refractory germ cell tumors treated with high-dose chemotherapy and autologous bone marrow rescue. DESIGN: Cohort study. SETTING: A university hospital. PATIENTS: Forty consecutive patients with recurrent or refractory germ cell tumors treated at Indiana University between September 1986 and June 1989. INTERVENTIONS: Patients were treated with high-dose carboplatin (900 to 2000 mg/m2 body surface area) and etoposide (1200 mg/m2). Three patients also received ifosfamide (10 g/m2). All patients had autologous bone marrow rescue. Of the 40 study patients, 26 received two full courses of therapy. MEASUREMENTS: Patient charts were reviewed to determine the rate and duration of complete and partial remission and the number of long-term, disease-free survivors. The influence of cisplatin-refractory disease and the site of the primary tumor on the incidence of remission and survival were also investigated. RESULTS: Of the 40 study patients, 26 (65%) responded to treatment; 12 (30%) achieved a complete response, and 14 (35%) achieved a partial response. Of the 12 complete responders, 5 relapsed, and 1 died of treatment-related acute leukemia 27.5 months after treatment without evidence of germ cell cancer. Six (15%) of the original 40 patients, of whom 3 were refractory to cisplatin, remained in complete remission after at least 24 months of follow-up. Eight of 40 patients had primary mediastinal germ cell tumors with no complete remissions and a median survival of 2 months (range, 0.5 to 9.0 months). CONCLUSIONS:
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Authors | E R Broun, C R Nichols, P Kneebone, S D Williams, P J Loehrer, L H Einhorn, G J Tricot |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 117
Issue 2
Pg. 124-8
(Jul 15 1992)
ISSN: 0003-4819 [Print] United States |
PMID | 1318648
(Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
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Topics |
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage)
- Bone Marrow Transplantation
- Cisplatin
(therapeutic use)
- Combined Modality Therapy
- Drug Resistance
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasms, Germ Cell and Embryonal
(therapy)
- Recurrence
- Remission Induction
- Salvage Therapy
- Testicular Neoplasms
(therapy)
- Treatment Outcome
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