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    High-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity.

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    Authors
    Decatris, M P
    Wilkinson, Peter M
    Welch, Richard
    Metzner, M
    Morgenstern, Godfrey R
    Dougal, Mark
    Affiliation
    Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK.
    Issue Date
    2000-04
    
    Metadata
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    Abstract
    BACKGROUND: The prognosis of patients with high-risk germ-cell cancer is poor. The toxicity and efficacy of first-line high-dose chemotherapy (HDCT) with stem-cell support was evaluated, following induction chemotherapy with BEP. PATIENTS AND METHODS: Twenty patients with poor prognosis non seminomatous germ-cell tumour by the International Consensus prognostic criteria received induction with BEP followed by one cycle of HDCT (CEC) given with carboplatin (1800 mg/m2), etoposide (1800 mg/m2), and cyclophosphamide (140 mg/kg). Of the above 20 patients only 3 received a second cycle of HDCT. Peripheral blood stem cells were infused on day 0. RESULTS: Twenty patients were assessable for toxicity and response. After a median follow-up of 27 months 15 patients (75%) are alive, 12 (60%) are disease free and 3 (15%) are alive with disease. Median survival has not been reached and overall survival at four years is 66% with a durable complete response rate of 50%. There were no deaths or cases of severe toxicity. Median time to a granulocyte count > 500/microl and platelets > 20,000/microl was 10 and 12 days respectively. Five patients have died from progressive disease 5-35 months after HDCT. CONCLUSIONS: These results support the case of first-line HDCT. The excellent toxicity profile of BEP/CEC and the two-year overall survival of 78% are encouraging and support further the ongoing randomised US intergroup study evaluating high-dose CEC after BEP.
    Citation
    High-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity. 2000, 11 (4):427-34 Ann. Oncol.
    Journal
    Annals of Oncology
    URI
    http://hdl.handle.net/10541/86471
    PubMed ID
    10847461
    Type
    Article
    Language
    en
    ISSN
    0923-7534
    Collections
    All Christie Publications

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