Improving the outcome of salvage treatment for non-seminomatous germ cell tumours (NSGCT)

Br J Cancer. 2000 Aug;83(4):426-30. doi: 10.1054/bjoc.2000.1290.

Abstract

Between 1991-96, 41 patients were treated in this unit for relapsed non-seminomatous germ cell tumours (NSGCT). Twenty-eight patients had raised markers at relapse: 17 required salvage chemotherapy and post-chemotherapy surgery, 11 only chemotherapy. In addition 9 patients received high dose chemotherapy. Overall 16/28 patients (57%) requiring chemotherapy remain alive, 14 (50%) disease free. Of the 17 patients treated with chemotherapy and surgery: 12 remain alive, 10 (59%) with no evaluable disease. Only 4/11 (36%) patients treated with chemotherapy alone remain alive, all in complete remission (CR). For relapse with raised markers, univariate analysis suggests that less than CR to induction therapy, resulting in the presence of residual disease is the most important predictor of poor outcome (P<0.001). All of the 13 patients relapsing with normal markers remain alive, having been primarily treated surgically. Overall these results indicate an improving outlook for relapsed NSGCT.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bleomycin / administration & dosage
  • Chorionic Gonadotropin / blood
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Dactinomycin / administration & dosage
  • Disease-Free Survival
  • Etoposide / administration & dosage
  • Humans
  • Ifosfamide / administration & dosage
  • Male
  • Methotrexate / administration & dosage
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / surgery
  • Retrospective Studies
  • Salvage Therapy
  • Teratoma / blood
  • Teratoma / drug therapy*
  • Teratoma / surgery*
  • Testicular Neoplasms / blood
  • Testicular Neoplasms / drug therapy*
  • Testicular Neoplasms / surgery*
  • Treatment Outcome
  • Vinblastine / administration & dosage
  • Vincristine / administration & dosage
  • alpha-Fetoproteins / metabolism

Substances

  • Chorionic Gonadotropin
  • alpha-Fetoproteins
  • Cytarabine
  • Bleomycin
  • Dactinomycin
  • Vincristine
  • Vinblastine
  • Etoposide
  • Cyclophosphamide
  • Cisplatin
  • Ifosfamide
  • Methotrexate

Supplementary concepts

  • ICE protocol 1
  • POMB-ACE protocol
  • VeIP protocol