High-dose chemotherapy plus peripheral blood stem cell transplantation for patients with relapsed germ cell tumors and active brain metastases.
Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Biomarkers, Tumor
/ blood
Brain Neoplasms
/ blood
Carboplatin
/ administration & dosage
Cause of Death
Chorionic Gonadotropin
/ blood
Combined Modality Therapy
/ methods
Cranial Irradiation
Drug Administration Schedule
Etoposide
/ administration & dosage
Humans
Kaplan-Meier Estimate
Male
Metastasectomy
Middle Aged
Neoplasm Recurrence, Local
/ blood
Neoplasms, Germ Cell and Embryonal
/ blood
Peripheral Blood Stem Cell Transplantation
Platelet Count
Platelet Transfusion
Radiosurgery
Young Adult
alpha-Fetoproteins
/ analysis
brain metastases
germ cell tumors
high-dose chemotherapy
peripheral blood stem cell transplant
relapsed germ cell tumor
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
15 03 2020
15 03 2020
Historique:
received:
26
06
2019
revised:
04
10
2019
accepted:
08
10
2019
pubmed:
20
11
2019
medline:
10
10
2020
entrez:
20
11
2019
Statut:
ppublish
Résumé
The optimal management of progressive brain metastases in patients with germ cell tumors (GCTs) remains unsettled. This study reports the management of 25 consecutive patients with relapsed GCTs and progressive brain metastases undergoing high-dose chemotherapy (HDCT) with peripheral blood stem cell transplantation (PBSCT) at Indiana University from 2006 to 2016. All patients were planned to undergo HDCT, which consisted of carboplatin at 700 mg/m Twenty-two of 25 patients completed both courses of HDCT. The median α-fetoprotein level was 7.5 ng/mL (range, 1.6-1130 ng/mL), and the human chorionic gonadotropin level was 31.3 IU/mL (range, 0.5-25,601 IU/mL). At a median follow-up of 24.5 months (range, 0.4-117 months), 11 patients (44%) were alive with no evidence of disease, 2 patients were alive with relapsed disease, and 12 patients had died of disease progression or complications from HDCT. Fifteen patients developed progressive brain metastases despite radiation and/or craniotomy before HDCT, and 8 of these patients were alive without evidence of disease. There were no intracranial hemorrhagic events leading to death. Patients with relapsed GCTs and progressive brain metastases are curable with multimodality therapy that includes HDCT and peripheral blood stem cell transplantation.
Sections du résumé
BACKGROUND
The optimal management of progressive brain metastases in patients with germ cell tumors (GCTs) remains unsettled. This study reports the management of 25 consecutive patients with relapsed GCTs and progressive brain metastases undergoing high-dose chemotherapy (HDCT) with peripheral blood stem cell transplantation (PBSCT) at Indiana University from 2006 to 2016.
METHODS
All patients were planned to undergo HDCT, which consisted of carboplatin at 700 mg/m
RESULTS
Twenty-two of 25 patients completed both courses of HDCT. The median α-fetoprotein level was 7.5 ng/mL (range, 1.6-1130 ng/mL), and the human chorionic gonadotropin level was 31.3 IU/mL (range, 0.5-25,601 IU/mL). At a median follow-up of 24.5 months (range, 0.4-117 months), 11 patients (44%) were alive with no evidence of disease, 2 patients were alive with relapsed disease, and 12 patients had died of disease progression or complications from HDCT. Fifteen patients developed progressive brain metastases despite radiation and/or craniotomy before HDCT, and 8 of these patients were alive without evidence of disease. There were no intracranial hemorrhagic events leading to death.
CONCLUSIONS
Patients with relapsed GCTs and progressive brain metastases are curable with multimodality therapy that includes HDCT and peripheral blood stem cell transplantation.
Substances chimiques
Biomarkers, Tumor
0
Chorionic Gonadotropin
0
alpha-Fetoproteins
0
Etoposide
6PLQ3CP4P3
Carboplatin
BG3F62OND5
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1202-1207Informations de copyright
© 2019 American Cancer Society.
Références
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