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Myeloablative chemotherapy and autologous stem cell transplantation in patients with relapsed or progressed central nervous system germ cell tumors: results of Korean Society of Pediatric Neuro-Oncology (KSPNO) S-053 study

Authors
 Hee Jo Baek  ;  Hyeon Jin Park  ;  Ki Woong Sung  ;  Soo Hyun Lee  ;  Jung Woo Han  ;  Kyung Nam Koh  ;  Ho Joon Im  ;  Hyoung Jin Kang  ;  Kyung Duk Park 
Citation
 JOURNAL OF NEURO-ONCOLOGY, Vol.114(3) : 329-338, 2013 
Journal Title
 JOURNAL OF NEURO-ONCOLOGY 
ISSN
 0167-594X 
Issue Date
2013
MeSH
Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Carboplatin/administration & dosage ; Central Nervous System Neoplasms/mortality* ; Central Nervous System Neoplasms/pathology ; Central Nervous System Neoplasms/therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Etoposide/administration & dosage ; Feasibility Studies ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Humans ; Male ; Melphalan/administration & dosage ; Myeloid Cells/pathology* ; Neoplasm Recurrence, Local/mortality* ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/therapy ; Neoplasms, Germ Cell and Embryonal/mortality* ; Neoplasms, Germ Cell and Embryonal/pathology ; Neoplasms, Germ Cell and Embryonal/therapy ; Prognosis ; Prospective Studies ; Salvage Therapy* ; Survival Rate ; Thiotepa/administration & dosage ; Transplantation, Autologous ; Young Adult
Keywords
Central nervous system germ cell tumor ; High-dose chemotherapy ; Autologous stem cell transplantation
Abstract
The present study evaluated the feasibility and effectiveness of myeloablative high-dose chemotherapy and autologous stem cell transplantation in patients with relapsed or progressed central nervous system germ cell tumors (CNS-GCTs). Eleven patients with non-germinomatous germ cell tumors and nine patients with germinomas were enrolled. Patients received between two and eight cycles of conventional chemotherapy prior to HDCT/autoSCT with or without radiotherapy. Overall, 16 patients proceeded to the first HDCT/autoSCT, and nine proceeded to the second HDCT/autoSCT. CTE (carboplatin-thiotepa-etoposide) and cyclophosphamide-melphalan (CM) regimens were used for the first and second HDCT, respectively. Toxicities during HDCT/autoSCT were acceptable, and there were no treatment-related deaths. Twelve patients experienced relapse or progression; however, four patients with germinomas remain alive after subsequent RT. Therefore, a total of 12 patients (four NGGCTs and eight germinomas) remain alive with a median follow-up of 47 months (range 22-90) after relapse or progression. The probability of 3-year overall survival was 59.1 ± 11.2 % (36.4 ± 14.5 % for NGGCTs vs. 88.9 ± 10.5 % for germinomas, P = 0.028). RT, particularly craniospinal RT, was associated with a better tumor response prior to HDCT/autoSCT and a better final outcome. In conclusion, HDCT/autoSCT was feasible, and survival rates were encouraging. Further study with a larger cohort of patients is needed to elucidate the role of HDCT/autoSCT in the treatment of relapsed or progressed CNS-GCTs.
Full Text
https://link.springer.com/article/10.1007%2Fs11060-013-1188-1
DOI
10.1007/s11060-013-1188-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Han, Jung Woo(한정우) ORCID logo https://orcid.org/0000-0001-8936-1205
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158399
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