title: [Chemotherapeutic intensification in germ cell tumors].
abstract: Chemotherapy has dramatically improved the prognosis of non-seminomatous germ cell tumors (NSGCT). However, some patients relapse and others are refractory to first line chemotherapy. We studied a salvage chemotherapeutic regimen with etoposide 75 gm/m2/day, and cisplatin 40 mg/m2/day, days 1-5 and Ifosfamide 3 g/m2/day, days 1 and 2 (VIhP regimen) in 32 patients. We observed 8 complete remissions with 4 long-term NED patients. Hematological, neurological and renal complications were frequent. In 16 other cases, a protocol using high dose chemotherapy, followed by autologous bone marrow rescue was studied. We observed 8 complete remissions with 4 long-term NED patients. These observations support a dose/effect relationship. A French randomized trial testing high dose chemotherapy, followed in some cases by an autologous marrow graft in poor risk advanced NSGCT, has recently been activated.
authors.affiliation: Département de médecine, Institut Gustave-Roussy, Villejuif, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Droz
authors.forename: J L
authors.initials: JL
authors.lastname: Pico
authors.forename: M
authors.initials: M
authors.lastname: Ghosn
authors.forename: M
authors.initials: M
authors.lastname: Ostronoff
authors.forename: M
authors.initials: M
authors.lastname: Azab
authors.forename: C
authors.initials: C
authors.lastname: Theodore
authors.forename: M
authors.initials: M
authors.lastname: Hayat
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D016026:Bone Marrow Transplantation; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003422:Critical Care; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004407:Dysgerminoma / Q000188:drug therapy* / Q000601:surgery; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D013094:Spermatozoa; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000601:surgery
chemical_list: D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin
vernacular_title: Intensification chimiothérapique dans les tumeurs germinales.