ISSN:
1569-8041
Keywords:
high-dose chemotherapy
;
poor prognosis germ-cell tumours
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background:The prognosis of patients with high-risk germ-cellcancer is poor. The toxicity and efficacy of first-line high-dose chemotherapy(HDCT) with stem-cell support was evaluated, following induction chemotherapywith BEP. Patients and methods:Twenty patients with poor prognosis nonseminomatous germ-cell tumour by the International Consensus prognosticcriteria received induction with BEP followed by one cycle of HDCT (CEC) givenwith carboplatin (1800 mg/m2), etoposide (1800 mg/m2),and cyclophosphamide (140 mg/kg). Of the above 20 patients only 3 received asecond cycle of HDCT. Peripheral blood stem cells were infused on day 0. Results:Twenty patients were assessable for toxicity andresponse. After a median follow-up of 27 months 15 patients (75%) arealive, 12 (60%) are disease free and 3 (15%) are alive withdisease. Median survival has not been reached and overall survival at fouryears is 66% with a durable complete response rate of 50%. Therewere no deaths or cases of severe toxicity. Median time to a granulocyte count〉500/µl and platelets 〉20,000/µl was 10 and 12 daysrespectively. Five patients have died from progressive disease 5–35months after HDCT. Conclusions:These results support the case of first-line HDCT.The excellent toxicity profile of BEP/CEC and the two-year overall survivalof 78% are encouraging and support further the ongoing randomised USintergroup study evaluating high-dose CEC after BEP.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008393512723
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