© 2005 European Society for Medical Oncology
Original article |
Second-line high-dose chemotherapy in patients with mediastinal and retroperitoneal primary non-seminomatous germ cell tumors: the EBMT experience
1 Istituto Oncologico Romagnolo-Santa Maria delle Croci Hospital, Ravenna, Italy; 2 Ankara University Medical School, Ankara, Turkey; 3 Klinikum Nuremberg, Germany; 4 University Hospital, Zürich, Switzerland; 5 Charite Humboldt University, Berlin, Germany; 6 University Hospital, Dresden, Germany; 7 University Hospital, Prague, Czech Republic; 8 Istituto Oncologico Romagnolo, Forlì, Italy
* Correspondence to: Dr U. De Giorgi, Department of Oncology and Hematology, Santa Maria delle Croci Hospital, viale Randi 5, I-48100 Ravenna, Italy. Tel: +39-0544-285247, Fax: +39-0544-285330; Email: ugo_degiorgi{at}yahoo.com
Background: Results of second-line chemotherapy in patients with extragonadal non-seminomatous germ cell tumor (NSGCT) appear inferior to results in testicular NSGCT. Patients with retroperitoneal NSGCT achieve a comparable long-term survival rate of 30%, but the salvage rates of patients with mediastinal primary are less than 10%. We conducted a retrospective analysis on patients with mediastinal and retroperitoneal NSGCT treated with second-line high-dose chemotherapy (HDCT) registered with the European Group for Blood and Marrow Transplantation (EBMT).
Patients and methods: Between 1987 and 1999, 59 registered patients with retroperitoneal (n=37) and mediastinal (n=22) primary NSGCT, median age 28 years (range 18–60), were treated with second-line HDCT. All had received cisplatin-containing chemotherapy as first-line treatment.
Results: Toxic death occurred in three cases (5%). With a median follow-up of 58 months (range 14–114), 18/59 patients (30%) continue to be disease-free. Of three patients who had a disease recurrence after HDCT, one patient achieved a disease-free status with further chemotherapy and surgery. In total, 19 patients (32%) are currently disease-free. Sixteen of 37 patients (43%) with retroperitoneal NSGCT, and three of 22 patients (14%) with mediastinal NSGCT are currently alive and disease-free.
Conclusions: Second-line HDCT might represent a possible option for patients with retroperitoneal primary NSGCT. New salvage strategies are needed for patients with mediastinal NSGCT.
Key words: EBMT, extragonadal, high-dose chemotherapy, non-seminomatous germ cell tumor, second-line chemotherapy
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  U. De Giorgi Is high-dose chemotherapy based on carboplatin, a late dose-intensification of a cisplatin-based salvage chemotherapy in germ cell tumour patients? Ann. Onc., March 1, 2006; 17(3): 530 - 531. [Full Text] [PDF]
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