Primary chemotherapy for XXXX : results of the second international CNS germ cell study group protocol.

@entity1 @entity2971 @entity3003 @entity900 @entity786 @entity2879 @entity1732
PURPOSE: The optimum therapy for @entity2971 ( @entity2971 ) remains controversial. The primary objective of this study was to determine whether intensive @entity900 and @entity786 -based combination chemotherapy was effective in @entity1 with intracranial @entity2971 . @entity1 AND METHODS: Twenty @entity1 were enrolled, aged 5 to 41 years (median, 13 years). Initial therapy included two courses of Regimen A ( @entity900 , @entity2879 , @entity786 , and @entity1732 ). @entity1 achieving a complete remission (CR) then received two courses of Regimen B ( @entity3003 , @entity2879 , and @entity1732 ). Those in CR after four courses of treatment received one additional course of Regimen A and Regimen B, while those not in CR after four treatment courses underwent second-look surgery and/or irradiation. RESULTS: Sixteen of 17 @entity1 assessable for response after two courses of treatment achieved a CR or partial response (CR + partial response, 0.94; 95% CI, 0.73 to 1.0). With a median follow-up of 6.3 years, 14 of 20 @entity1 are alive without disease; eight @entity1 were without relapse or progression, of whom three received local irradiation in first complete remission in violation of protocol, and six @entity1 were in durable second or third complete remission after further chemotherapy and/or irradiation. The 5-year overall survival and event-free survival were 0.75 (95% CI, 0.56 to 0.94) and 0.36 (95% CI, 0.13 to 0.59), respectively. CONCLUSION: Intensive chemotherapy was effective in one-third of @entity1 in this study. Salvage therapy, including irradiation, was feasible in @entity1 with recurrent disease.
