Thiotepa-Based High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Recurrent or Progressive CNS Germ Cell Tumors

Abstract

Dose escalation of chemotherapy followed by ASCR is effective therapy for patients with recurrent CNS germinomas and might be effective in patients with recurrent NGGCTs with a low tumor burden.

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

“…Therefore, HDC could be a possible option as salvage treatment for extracranial GCTs. Our results for intracranial GCTs, including only one germinoma, are similar to those of other major experiences for nongerminomatous CNS GCTs (Modak et al, 2004). The 2-year overall survival rates for first relapsing patients and second -third relapsing extragonadal GCT patients were clearly different: 78 and 43%, respectively.…”

“…Out of the 21 patients, 11 (52%) achieved long-term disease-free survival. Results were clearly better for germinomas (seven of nine patients, 78%, disease-free continuously), than for nongerminomatous GCTs (four of 12 patients, 33%, long-term disease-free) (Modak et al, 2004). Recently, a regimen including high doses of cisplatin has been compared to standard-dose chemotherapy as primary treatment in a randomised study in 299 children with high-risk GCTs, including 165 extragonadal GCTs.…”

“…High-dose chemotherapy is currently investigated as a possible option for high-risk and recurrent CNS GCTs, and is used on an individual basis as salvage therapy for children with other extragonadal germ-cell malignancies (Calaminus and Patte, 2002;Cushing et al, 2004;Kellie et al, 2004;Modak et al, 2004). Few series with salvage chemotherapy for relapse GCT patients with extragonadal primary are reported in literature.…”

Pre‐radiation chemotherapy with response‐based radiation therapy in children with central nervous system germ cell tumors: A report from the Children's Oncology Group

“…Ten of 11 evaluable patients with low-risk germinoma achieved CR or PR on central review, which compares favorably to other series [3,12,13,15,16,19,35,38,[40][41][42]. In the most recent series 10 of 11 patients with pure germinomas were disease-free, whereas 5 of 11 patients with elevated CSF HCG relapsed, including 2 with HCG 101-233 mIU/ml, after chemotherapy plus local RTof 24 Gy [15].…”

Myeloablative chemotherapy with autologous hematopoietic progenitor cell rescue for childhood central nervous system tumors

“…Myeloablative chemotherapy is effective in patients with recurrent germinoma (480% cure rate) but is less effective in recurrent mixed malignant germ-cell tumors, in whom fewer than 50% are long-term survivors. 41,42 Acute and long-term toxicities The almost universal complications after HDC are pancytopenia and mucositis. The duration and severity of pancytopenia is a consequence of several variables related to the hematopoietic stem cells reinfused (or persisting) after HDC and the ability of the stroma to sustain hematopoieisis.…”