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Gewählte Publikation:

Pont, J; Bokemeyer, C; Harstrick, A; Sellner, F; Greinix, H; Stoiber, F.
Chemotherapy for germ cell tumors relapsing after high-dose chemotherapy and stem cell support: a retrospective multicenter study of the Austrian Study Group on Urologic Oncology.
Ann Oncol. 1997; 8(12):1229-1234 Doi: 10.1023/A:1008286305312 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Greinix Hildegard

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In most patients with advanced refractory germ cell tumors undergoing high-dose chemotherapy with stem cell support (HDCT) the disease progresses after HDCT. This study was designed to shed light on the unestablished role of post-HDCT chemotherapy. In a retrospective multicenter study data of 47 evaluable patients from nine centers subjected to post-HDCT chemotherapy for progression of their germ cell tumors were collected in a questionnaire survey and analyzed for treatment response and survival. Of 191 patients pretreated by HDCT, 48 (25%) were subjected to post-HDCT chemotherapy for disease progression. Remission was achieved in 17 (36%) and marker-negative remission in eight (17%). The median survival time was 26 weeks, 65 weeks for responders and 13 weeks for non-responders. Only one of 47 evaluable patients achieved sustained complete remission. Remissions significantly correlated with the post-HDCT interval, the use of ifosfamide and the combination regimens of cisplatin + etoposide i.v. or ifosfamide and of paclitaxel + ifosfamide or cisplatin. On univariate analysis a longer post-HDCT interval, the use of cisplatin, paclitaxel and ifosfamide and the combined use of paclitaxel + ifosfamide and/or cisplatin significantly improved the chances of survival. On multivariate analysis only treatment with paclitaxel and ifosfamide retained independent prognostic significance for survival. One third of the patients considered to be candidates for further chemotherapy once progressive after HDCT went into remission with a gain in survival time. Sustained remissions may occur, but are rarely seen. Paclitaxel and ifosfamide appear to be the most effective drugs in these heavily pretreated patients.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Antineoplastic Agents - administration & dosage Antineoplastic Agents - adverse effects
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols -
Cisplatin - therapeutic use
Cisplatin -
Germinoma - drug therapy
Humans -
Male -
Middle Aged -
Retrospective Studies -
Survival Analysis -
Survival Analysis -
Testicular Neoplasms - drug therapy
Treatment Outcome -

Find related publications in this database (Keywords)
cisplatin-refractory patients
germ cell cancer
post-HDCT chemotherapy
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