title: Cerebral metastases in non-seminomatous germ cell tumour patients undergoing primary high-dose chemotherapy.
abstract: BACKGROUND
  Retrospective analysis of characteristics and outcome of germ cell tumour (GCT) patients with cerebral metastases (CM) undergoing high-dose chemotherapy (HD-CTX) or relapsing with CM.
  
  
  METHODS
  Patients initially presenting with CM (N=50 pts) or at first relapse (n=19 pts) after primary HD-CTX (434 pts) were analysed.
  
  
  RESULTS
  Patients with primary CM (N=50) had elevated ss-human chorion gonadotropin (ss-HCG) in 88% and lung metastases in 90%. Eighty six percent responded to HD-CTX and 40% underwent CNS radiotherapy. Forty four percent achieved long-term survival after primary and 16% after salvage treatment (60% in total). All patients relapsing with CM (n=19) presented initially with ss-HCG-elevation and pulmonary metastases. Treatment consisted of CTX in 78%, irradiation in 90% and surgery in 63%. Twenty six percent achieved long-term survival.
  
  
  CONCLUSIONS
  An interdisciplinary approach of HD-CTX, radiotherapy and surgery leads to long-term survival in 60% of patients with CM at initial diagnosis and 26% relapsing with CM.
authors.affiliation: Department of Oncology, University Medical Center Eppendorf, Hamburg, Germany. k.oechsle@uke.hamburg.de
authors.forename: K
authors.initials: K
authors.lastname: Oechsle
authors.forename: C
authors.initials: C
authors.lastname: Kollmannsberger
authors.forename: F
authors.initials: F
authors.lastname: Honecker
authors.forename: I
authors.initials: I
authors.lastname: Boehlke
authors.forename: C
authors.initials: C
authors.lastname: Bokemeyer
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D013736:Testicular Neoplasms; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin