title: High-dose chemotherapy as initial salvage chemotherapy in patients with relapsed testicular cancer.
abstract: OBJECTIVE
  To assess the role of high-dose chemotherapy as initial salvage chemotherapy in patients with relapsed testicular cancer.
  
  
  METHODS
  From August 1992 to April 1998, 65 patients with testicular cancer were treated with high-dose carboplatin and etoposide followed by peripheral-blood stem-cell transplantation or autologous bone marrow transplantation rescue as initial salvage chemotherapy at Indiana University. An identical course was given after hematopoietic reconstitution. Postchemotherapy resection of residual disease was performed in selected patients with incomplete radiographic response associated with normalization of markers. The median follow-up was 39 months (range, 16 to 91 months).
  
  
  RESULTS
  Thirty-seven (57%) of the 65 patients are continuously disease-free. Three additional patients are disease-free with subsequent surgery. High-dose chemotherapy was associated with significant morbidity but no treatment-related mortality.
  
  
  CONCLUSIONS
  High-dose chemotherapy as initial salvage chemotherapy achieved impressive long-term survival with acceptable toxicity in patients with relapsed testicular cancer.
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, Indiana University Medical Center, Indianapolis, IN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Bhatia
authors.forename: R
authors.initials: R
authors.lastname: Abonour
authors.forename: P
authors.initials: P
authors.lastname: Porcu
authors.forename: R
authors.initials: R
authors.lastname: Seshadri
authors.forename: C R
authors.initials: CR
authors.lastname: Nichols
authors.forename: K
authors.initials: K
authors.lastname: Cornetta
authors.forename: L H
authors.initials: LH
authors.lastname: Einhorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002822:Choriocarcinoma / Q000188:drug therapy / Q000473:pathology; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D018237:Germinoma / Q000188:drug therapy* / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D018239:Seminoma / Q000188:drug therapy / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D016190:Carboplatin