title: Feasibility and usefulness of high-dose chemotherapy (high-dose ifosfamide, carboplatin and etoposide) combined with peripheral blood stem cell transplantation for male germ cell tumor: a single-institute experience.
abstract: Although the usefulness of high-dose chemotherapy with peripheral blood stem cell transplantation for advanced germ cell tumor is still under evaluation in phase III randomized controlled studies, this approach is currently used as one treatment option for relapsed or advanced male germ cell tumor. Clinical outcomes of high-dose chemotherapy for a single institute from Japan are presented herein. We administered 63 courses of high-dose ifosfamide, carboplatin and etoposide chemotherapy (1250 mg/m carboplatin; 1500 mg/m etoposide; 7.5 g/m ifosfamide) to 34 men with germ cell tumors. Of these, 27 patients underwent high-dose ifosfamide, carboplatin and etoposide as first-line therapy after 2-3 courses of conventional bleomycin, etoposide and cisplatin chemotherapy, and seven patients underwent high-dose ifosfamide, carboplatin and etoposide for relapsed germ cell tumor. Peripheral blood stem cells were harvested during previous chemotherapy and sufficient CD34 cells were harvested for transplantation. Although all patients experienced grade 4 hemotoxicity, leukocyte counts recovered to above 1000/mul within 8-11 days after peripheral blood stem cell transplantation. No treatment-related deaths occurred. After a mean follow-up of 45 months (range 12-118 months), 23 of 34 patients (67.6%) remained disease-free. High-dose ifosfamide, carboplatin and etoposide could be performed safely, and could offer an effective means of treating advanced or refractory germ cell tumors in men.
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. hara@med.kobe-u.ac.jp
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Junya
authors.initials: J
authors.lastname: Furukawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kumano
authors.forename: Atsuhi
authors.initials: A
authors.lastname: Takenaka
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D018237:Germinoma / Q000628:therapy; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D013736:Testicular Neoplasms / Q000628:therapy*
chemical_list: D001761:Bleomycin; D005047:Etoposide; D016190:Carboplatin; D002945:Cisplatin; D007069:Ifosfamide