[Chemotherapy of germ-cell tumors of poor prognosis and role of intensification with hematological support].
Poor-risk germ-cell tumors are defined by the presence of high serum tumor marker and large tumor burden. The standard treatment of this group of patients is four cycles of a combination of bleomycin, etoposide and cisplatin followed by the surgical exeresis of residual disease. Neither cisplatin dose-intensification nor alternating chemotherapy protocols, high-dose induction protocols and high-dose consolidation regimens have demonstrated better results than the standard chemotherapy regimen. The salvage treatment of germ-cell tumors is a combination of vinblastine, ifosfamide and cisplatin followed by the surgical exeresis of residual disease. The role of high-dose consolidation chemotherapy is studied in an international randomized trial. However high-dose chemotherapy is inactive in refractory disease patients. Innovative trials are developed in this group of patients.
Droz
J P
JP
Départment de Cancérologie médicale, Centre Léon Bérard.
Culine
S
S
Biron
P
P
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D018237:Germinoma / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011379:Prognosis
Chimiothérapie des tumeurs germinales de mauvais pronostic et place des intensifications avec support hématologique.