High-dose chemotherapy as salvage treatment for seminoma.
Between October 1989 and February 1997, 13 patients with refractory or relapsed seminomas were treated with high-dose chemotherapy (HDCT) as part of consecutive phase I/II studies. Six patients had failed prior cisplatin-based first-line treatments and seven patients had also failed cisplatin-based salvage treatments. After HDCT 4/12 (33%) patients became disease-free, 4/12 (33%) patients achieved partial remissions and 4/12 (33%) patients suffered progressive disease despite HDCT. One patient developed multiorgan failure and died. With a median follow-up of 4.5 years (range 3.4 to 8 years) five patients (38%) are alive and eight patients (62%) have died. Patients with non-pulmonary visceral metastases, with short relapse-free intervals and with cisplatin-refractory tumors were more likely to fail. HDCT can be curative in seminoma patients even if offered as second salvage treatment.
Medizinische Klinik mit Schwerpunkt Hämatologie/Onkologie, Universitätsklinikum Charité, Campus Virchow-Klinikum, Berlin, Germany.
O
O
Rick
W
W
Siegert
N
N
Schwella
M
M
Dubiel
A
A
Krusch
J
J
Beyer
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000633:toxicity; D016026:Bone Marrow Transplantation; D002945:Cisplatin / Q000008:administration & dosage; D004067:Digestive System Neoplasms / Q000556:secondary; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D018239:Seminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D014182:Transplantation, Autologous; D017211:Treatment Failure
D002945:Cisplatin