[Rescue chemotherapy in testicular germ cell tumors].

Abstract

OBJECTIVE:

To review the different salvage chemotherapy regimens according to the prognostic factors based on the response to the different therapeutic alternatives.

METHODS:

The conventional rescue chemotherapy regimens, as well as the role of surgery, new drugs and therapeutic modalities, particularly high dose second and third line chemotherapy, were reviewed.

RESULTS/CONCLUSIONS:

Germ cell testicular tumor is the paradigm of curable tumors of the adult. Whereas the cure rate for stage I tumors is higher than 98%, patients with advanced stage tumors have a lower cure rate. Approximately 10% of the patients with good-prognosis factors and 30%-50% of those with poor-prognosis factors show tumor progression or recurrence after first line chemotherapy using cisplatin-based combinations. Patients who have recurrence after first line chemotherapy have a 40% probability of achieving second complete remission with second line chemotherapy, but will be sustained in only 20% of the patients, although rare cases of advanced pure seminoma that recurred have shown a cure rate of 55% with second line chemotherapy. New strategies have been developed using new drugs such as taxanes or high doses of well-known chemotherapeutic agents with autologous hematopoietic rescue that have been utilized with success in patients with refractory germ cell testicular tumors. A global analysis of the patients treated with third line chemotherapy shows a sustained complete remission rate of 22%. However, this percentage can only be increased to up to 50% for patients with no adverse factors.

• Authors: R Salazar Soler, P Maroto Rey, C Solà Rocabert, J J López López
• Journal: Archivos espanoles de urologia (Arch Esp Urol) 2000 Jul-Aug Vol. 53 Issue 6 Pg. 554-64 ISSN: 0004-0614 [Print] Spain
• Vernacular Title: Quimioterapia de rescate en tumores de células germinales testiculares.
• PMID: 11002524 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (therapeutic use)
• Germinoma (drug therapy)
• Humans
• Male
• Neoplasm Recurrence, Local (epidemiology)
• Prognosis
• Testicular Neoplasms (drug therapy)