Salvage high-dose chemotherapy for children with extragonadal germ-cell tumours

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De Giorgi U., Rosti G., Slavin S., Yaniv I., Harousseau J., Ladenstein R., ...Daha Fazla

BRITISH JOURNAL OF CANCER, cilt.93, sa.4, ss.412-417, 2005 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 93 Sayı: 4
  • Basım Tarihi: 2005
  • Doi Numarası: 10.1038/sj.bjc.6602724
  • Dergi Adı: BRITISH JOURNAL OF CANCER
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.412-417
  • Anahtar Kelimeler: extragonadal germ cell tumour, high-dose chemotherapy, salvage therapy, children, ADOLESCENTS, CHILDHOOD, RECURRENT, EXPERIENCE, BLEOMYCIN, ETOPOSIDE
  • Ankara Üniversitesi Adresli: Evet

Özet

We reviewed the European Group for Blood and Marrow Transplantation (EBMT) experience with salvage high-dose chemotherapy (HDC) in paediatric patients with extragonadal germ-cell tumour (GCT). A total of 23 children with extragonadal GCT, median age 12 years ( range 1 - 20), were treated with salvage HDC with haematopoietic progenitor cell support. The GCT primary location was intracranial site in nine cases, sacrococcyx in eight, retroperitoneum in four, and mediastinum in two. In all, 22 patients had a nongerminomatous GCT and one germinoma. Nine patients received HDC in first- and 14 in second- or third-relapse situation. No toxic deaths occurred. Overall, 16 of 23 patients (70%) achieved a complete remission. With a median follow-up of 66 months ( range 31 - 173 months), 10 (43%) are continuously disease-free. Of six patients who had a disease recurrence after HDC, one achieved a disease-free status with surgical resection followed by chemotherapy and radiotherapy. In total, 11 patients (48%) are currently disease-free. Eight of 14 patients (57%) with extracranial primary and three of nine patients (33%) with intracranial primary GCT are currently disease-free. HDC induced impressive long-term remissions as salvage treatment in children with extragonadal extracranial GCTs. Salvage HDC should be investigated in prospective trials in these patients.