title: Improving the outcome of salvage treatment for non-seminomatous germ cell tumours (NSGCT).
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.
authors.affiliation: University of Glasgow, Department of Medical Oncology, Western Infirmary, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: de Bono
authors.forename: J
authors.initials: J
authors.lastname: Paul
authors.forename: A
authors.initials: A
authors.lastname: Simpson
authors.forename: A
authors.initials: A
authors.lastname: Anthoney
authors.forename: D
authors.initials: D
authors.lastname: Kirk
authors.forename: M
authors.initials: M
authors.lastname: Underwood
authors.forename: J
authors.initials: J
authors.lastname: Graham
authors.forename: S B
authors.initials: SB
authors.lastname: Kaye
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D006063:Chorionic Gonadotropin / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000188:drug therapy / Q000601:surgery; D012189:Retrospective Studies; D016879:Salvage Therapy; D013724:Teratoma / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D003561:Cytarabine; D001761:Bleomycin; D003609:Dactinomycin; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate