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Cerebral metastases in non-seminomatous germ cell tumour patients undergoing primary high-dose chemotherapy
K Oechsle1, C Kollmannsberger, F Honecker
1Department of Oncology, University Medical Center Eppendorf, Hamburg, Germany. k.oechsle@uke.hamburg.de
Background:
Retrospective analysis of characteristics and outcome of germ cell tumour (GCT) patients with cerebral metastases (CM) undergoing high-dose chemotherapy (HD-CTX) or relapsing with CM.
Patients And Methods:
Patients initially presenting with CM (N=50 pts) or at first relapse (n=19 pts) after primary HD-CTX (434 pts) were analysed.
Results:
Patients with primary CM (N=50) had elevated ss-human chorion gonadotropin (ss-HCG) in 88% and lung metastases in 90%. Eighty six percent responded to HD-CTX and 40% underwent CNS radiotherapy. Forty four percent achieved long-term survival after primary and 16% after salvage treatment (60% in total). All patients relapsing with CM (n=19) presented initially with ss-HCG-elevation and pulmonary metastases. Treatment consisted of CTX in 78%, irradiation in 90% and surgery in 63%. Twenty six percent achieved long-term survival.
Conclusion:
An interdisciplinary approach of HD-CTX, radiotherapy and surgery leads to long-term survival in 60% of patients with CM at initial diagnosis and 26% relapsing with CM.
