[Current status of chemotherapy of germ cell tumors]

With the advent of modern chemotherapy the dismal prognosis of disseminated germ cell tumors has changed, and there is now an overall survival rate of 90%. This review gives an overview of the historical development of chemotherapy of germ cell cancer. The stage-specific indications for chemotherapy in the management of germ cell tumors are outlined. The standard regimen is the combination of cisplatin, etoposide, and bleomycin, which is given in three to four cycles for inductive therapy and in two cycles as adjuvant therapy. Carboplatin is very active in the management of advanced seminoma, and it is also given in high-dose regimes during salvage therapy for relapses. Ifosfamide is a second-line drug and is indicated in the treatment of relapses and marker-positive residual tumors.