Treatment of Recurrent Malignant Sacrococcygeal Germ Cell Tumors: Analysis of 22 Patients Registered in the German Protocols MAKEI 83/86, 89, and 96

Schneider, Dominik T.; Wessalowski, Rüdiger; Calaminus, Gabriele; Pape, H.; Bamberg, M.; Engert, J.; Waag, Karl-Ludwig; Gadner, H.; Göbel, U.

doi:10.1200/jco.2001.19.7.1951

Cited by 67 publications

(66 citation statements)

References 18 publications

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“…On the other hand, patients with severe cisplatinum-related toxicity may be treated with a combination of carboplatinum and high-dose etoposide (at 400-600 mg/m 2 on 3 days). In our experience, high-dose chemotherapy with stem cell support, as it has been applied in adult patients [61], resulted in long-term remissions only in those patients in whom a clinical complete remission could be achieved prior to high-dose chemotherapy [60]. Therefore, we would tend to reserve high-dose chemotherapy to consolidation treatment.…”

Section: Relapse Treatmentmentioning

confidence: 99%

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Management of Germ Cell Tumors in Children: Approaches to Cure

Göbel

Calaminus²,

Schneider³

et al. 2002

Oncol Res Treat

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The introduction of cisplatinum chemotherapy and current advances in the surgical treatment have resulted in a dramatic improvement of the prognosis of children with malignant germ cell tumors (GCT). Cisplatinum chemotherapy generally results in sufficient systemic tumor control, but local relapses may still occur in patients who did not receive adequate local treatment. Therefore, the therapeutic consideration must take into account age, primary site of the tumor, and its histology. In gonadal tumors, there is a high chance of primary complete resection since these tumors tend to be encapsulated, and particularly testicular GCT are often detected at a low tumor stage. In contrast, a primary complete resection may be impossible in large nongonadal tumors such as sacrococcygeal or mediastinal GCT. In these tumors, a neoadjuvant or preoperative chemotherapy after clinical diagnosis by imaging and evaluation of tumor markers significantly facilitates complete resection on delayed surgery. In addition, the impact of chemotherapy on local tumor control may be enhanced by locoregional hyperthermia. In most intracranial GCT complete resection is impossible and may be associated with significant morbidity. Nevertheless, biopsy is essential for diagnosis in nonsecreting tumors. In intracranial GCT, radiotherapy significantly contributes to local tumor control, and doses are stratified according to histology. These general considerations have been integrated into national and international cooperative treatment protocols. In most current protocols, treatment is stratified according to an initial risk assessment that includes the parameters age, site, histology, stage, completeness of resection and the tumor markers alpha₁-fetoprotein (AFP) and human choriogonadotropin (β-HCG). With such modern protocols overall cure rates above 80% can be achieved. Moreover, the previously high-risk groups may now expect a favorable prognosis with this riskadapted treatment, whereas an increasing number of low-risk patients are treated expectantly or with significantly reduced chemotherapy. As current biologic studies reveal distinct genetic patterns in childhood GCT, it can be expected that further combined clinical and genetic studies will be valuable for risk assessment of childhood GCT.

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Section: Relapse Treatmentmentioning

confidence: 99%

“…In general, there is no role for debulking surgery in pediatric GCT. Usually, surgery of metastases is not indicated unless they show insufficient response to chemotherapy [42,46,60].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Management of Germ Cell Tumors in Children: Approaches to Cure

Göbel

Calaminus²,

Schneider³

et al. 2002

Oncol Res Treat

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“…Glioblastoma is currently treated with surgery, radiotherapy, and chemotherapy (Byun et al 2006;Chang et al 2007;Patel and Mehta 2007). The current therapeutic strategies are effective only in the less advanced stages of the disease, in which the tumor mass is localized (Feelders et al 2009;Schneider et al 2001). However, the recurrence rate is high (Kioi et al 2010;Sharma et al 2010;Wen 2010).…”

Section: Introductionmentioning

confidence: 99%

Static magnetic field controls cell cycle in cultured human glioblastoma cells

Kim

Shim

et al. 2016

Cytotechnology

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Magnetic field has been widely used in clinical diagnostics or for clinical treatment and is an important biomedical technology. Glioblastoma multiforme U87 and U251 are models of a fast growing malignant cancer. We focused on cellular level drafting of these cell lines as a time-dependent effect indicator of static magnetic fields (2000 ± 600 Gauss) by using their fast-growing properties. Cell viability showed a significant decrease (p \ 0.01). The results coincided with the occurrence of apoptotic signals or protein expression of cyclin B1 and cyclin dependent kinase 1 in a non-apoptotic manner. Cdk1 was decreased in proportion to ankyrin G and cyclin B1 (Chi-square test, p = 0.0366). Our findings suggest that static magnetic stimulation creates a specific cytoproliferative pattern, rather than producing randomized growth impairment.

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“…Standard-dose cisplatin-or carboplatin-based chemotherapy is the conventional treatment for most of these patients. In patients with local recurrence of sacrococcygeal GCT, the surgical complete resection represents the cornerstone of the salvage treatment, while chemotherapy is employed in recurrent inoperable and metastatic disease (Schneider et al, 2001). In patients with recurrent CNS GCTs, chemotherapy alone or combined with radiotherapy has to be considered, if feasible (Sawamura et al, 1999;Kellie et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Few series with salvage chemotherapy for relapse GCT patients with extragonadal primary are reported in literature. The largest experience with different salvage standard-dose chemotherapeutic approaches, more often including cisplatin-based chemotherapy, in relapse patients with sacrococcygeal GCT showed 10 of the 22 patients (45%) disease-free at a median followup of 56 months (Schneider et al, 2001). Other authors investigated the use of salvage treatments including standard-dose chemotherapy and/or HDC in patients with relapsed CNS GCT (Calaminus and Patte, 2002;Kellie et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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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.

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Treatment of Recurrent Malignant Sacrococcygeal Germ Cell Tumors: Analysis of 22 Patients Registered in the German Protocols MAKEI 83/86, 89, and 96

Cited by 67 publications

References 18 publications

Management of Germ Cell Tumors in Children: Approaches to Cure

Management of Germ Cell Tumors in Children: Approaches to Cure

Static magnetic field controls cell cycle in cultured human glioblastoma cells

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

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