Evaluation of High-Dose Chemotherapy and Autologous Stem Cell Transplant in Salvage Treatment of Extragonadal Germ Cell Tumours

Abstract

Background We aimed to evaluate the survival analysis, response rates and factors affecting response to high-dose chemotherapy (HDCT) and autologous stem cell transplantation (OSCT) in patients with relapsed/refractory extragonadal germ cell tumours. Methods The study included patients diagnosed with extragonadal germ cell tumors who underwent HDCT + ASCT between November 2016 and January 2023 at Gülhane Training and Research Hospital. Clinical characteristics and follow-up data were retrospectively analyzed from patient records and the hospital electronic system. Patients under 18 years of age and those without medical records were excluded. Patient characteristics, post-HDCT progression-free survival (PFS), overall survival (OS) data, factors affecting survival, and treatment-related mortality (TRM) were examined. The relationship between clinical factors and OS/PFS was analyzed. Results Twenty-five patients were included. After HDCT + ASCT, complete response (CR) was observed in 6 patients (24%), partial response (PR) in 15 patients (60%) and progressive disease (PD) in 4 patients (16%). TRM was observed in 1 (4%) patient. Median follow-up was 25.4 months. Median PFS and OS after HDCT + ASCT were calculated to be 4.9 months and 12.2 months, respectively. Conclusions Salvage HDCT + ASCT is an option in the treatment of extragonadal germ cell tumours, offering the potential for prolonged survival and cure.