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dc.contributor.authorMurray, MJ
dc.contributor.authorBailey, S
dc.contributor.authorHeinemann, K
dc.contributor.authorMann, J
dc.contributor.authorGöbel, UK
dc.contributor.authorSaran, F
dc.contributor.authorHale, JP
dc.contributor.authorCalaminus, G
dc.contributor.authorNicholson, JC
dc.date.accessioned2018-02-15T09:01:59Z
dc.date.issued2017-08
dc.identifier.citationInternational journal of cancer, 2017, 141 (3), pp. 621 - 635
dc.identifier.issn0020-7136
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1092
dc.identifier.eissn1097-0215
dc.identifier.doi10.1002/ijc.30755
dc.description.abstractWe aimed to retrospectively assess treatments/outcomes, including the value of high-dose-chemotherapy and autologous-stem-cell-rescue (HDC + AuSCR) and re-irradiation, in a large, European patient-cohort with relapsed intracranial germ-cell-tumors (GCTs) receiving uniform first-line therapy, including radiotherapy as standard-of-care. Fifty-eight UK/German patients (48 male/10 female) with relapsed intracranial-GCTs [13 germinoma/45 non-germinomatous GCT (NGGCT)] treated 1996-2010 as per the SIOP-CNS-GCT-96 protocol were evaluated. For germinoma, six patients relapsed with germinoma and five with NGGCT (one palliative, one teratoma patient excluded). Five-year overall-survival (OS) for the whole-group (n = 11) was 55%. Four of six germinoma relapses and two of five relapsing with NGGCT were salvaged; patients were salvaged with either standard-dose-chemotherapy (SDC) and re-irradiation or HDC + AuSCR with/without re-irradiation. Of 45 relapsed NGGCT patients, 13 were excluded (three non-protocol adherence, five teratoma, five palliation). Five-year OS for the remaining 32 relapsed malignant NGGCT patients treated with curative intent was 9% (95%CI: 2-26%). By treatment received, 5-year OS for the 10 patients receiving SDC and 22 patients treated with intention for HDC + AuSCR was 0% (0-0%) and 14% (3-36%), respectively. The three relapsed NGGCT survivors had raised HCG markers alone; two received additional irradiation. Patients with relapsed germinoma had better 5-year OS than those with relapsed NGGCT (55 vs. 9%; p = 0.007). Patients with relapsed germinoma were salvaged both with SDC and re-irradiation or HDC + AuSCR with/without re-irradiation; both represent valid treatment options. Outcomes for malignant relapse following initial diagnosis of NGGCT were exceptionally poor; the few survivors received thiotepa-based HDC + AuSCR, which is a treatment option at first malignant relapse for such patients, with further surgery/irradiation where feasible.
dc.formatPrint-Electronic
dc.format.extent621 - 635
dc.languageeng
dc.language.isoeng
dc.subjectHumans
dc.subjectNeoplasms, Germ Cell and Embryonal
dc.subjectGerminoma
dc.subjectBrain Neoplasms
dc.subjectNeoplasm Recurrence, Local
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectNeoplasm Staging
dc.subjectPrognosis
dc.subjectCombined Modality Therapy
dc.subjectSurvival Rate
dc.subjectRetrospective Studies
dc.subjectFollow-Up Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectInfant
dc.subjectGermany
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.subjectUnited Kingdom
dc.titleTreatment and outcomes of UK and German patients with relapsed intracranial germ cell tumors following uniform first-line therapy.
dc.typeJournal Article
dcterms.dateAccepted2017-04-06
rioxxterms.versionofrecord10.1002/ijc.30755
rioxxterms.licenseref.startdate2017-08
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfInternational journal of cancer
pubs.issue3
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume141en_US
pubs.embargo.termsNot known
dc.contributor.icrauthorMarsden,en


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