title: Treatment of brain metastases from germ cell tumors.
abstract: Brain metastases occur in approximately 10% of patients with advanced metastatic germ cell tumors. Patients with nonseminomatous histology, lung metastases, and high β-human chorionic gonadotropin levels are at higher risk for synchronous brain metastases at first diagnosis and for relapsing with brain metastases after successful cisplatin-based chemotherapy. Patients with brain metastases should undergo multimodal treatment strategies, including cisplatin-based combination chemotherapy plus radiotherapy or surgery. However, the optimal combination and sequence of these strategies remain unclear and may differ between subgroups. But in all cases, chemotherapy must be part of treatment, even in patients with isolated cerebral relapse without systemic disease.
authors.affiliation: Department of Oncology/Hematology/Bone Marrow Transplantation/Pneumology, University Medical Center Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Oechsle
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000528:radiation effects / Q000601:surgery; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000556:secondary / Q000628:therapy; D019635:Neurosurgical Procedures; D011878:Radiotherapy; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy