[Chemotherapeutic intensification in germ cell tumors].
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.
Droz
J P
JP
Département de médecine, Institut Gustave-Roussy, Villejuif, France.
Pico
J L
JL
Ghosn
M
M
Ostronoff
M
M
Azab
M
M
Theodore
C
C
Hayat
M
M
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
D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin
Intensification chimiothérapique dans les tumeurs germinales.