Improved Survival after Brain Metastases in Nonseminomatous Germ Cell Tumours with Combined Modality Treatment

Mackintosh, J.; Fox, Richard M.; Rogers, John; Duval, P.; Besser, Michael

doi:10.1111/j.1464-410x.1987.tb04987.x

Cited by 19 publications

(7 citation statements)

References 6 publications

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“…Although Rustin et al [ 13] reported long‐term survival for eight of 10 patients with brain metastases receiving chemotherapy alone, others have used combination therapy (chemotherapy with or without radiotherapy or surgery) [ 3, 5, 8]. The major concern in the chemotherapeutic approach has been the difficulty of obtaining adequate cytotoxic concentrations of chemotherapeutic agents in the CNS.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery has been used for large metastases with mass effect, isolated relapses in the brain, or for the treatment of residual large masses [ 5]. The prognosis is better for those patients who had brain metastasis at presentation, isolated relapses in the brain and single brain metastasis [ 3, 5, 8].…”

Section: Discussionmentioning

confidence: 99%

“…In general, patients with brain metastases from NSGCTs have been regarded as having a very poor prognosis, with a mean survival of 2–3 months [ 2, 4]. More recently, longer survival in selected patients with brain metastasis has been reported [ 3, 5, 7, 8]. Thus, the aim of the present study was to report our experience in this field and analyse the clinical data of patients with brain metastases from NSGCTs.…”

Section: Introductionmentioning

confidence: 99%

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The management of brain metastasis in nonseminomatous germ cell tumours

et al. 1999

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Objective To review our experience of patients with patients with advanced thoracic disease was 32% (11/34). Four patients with brain metastases at presenbrain metastases from nonseminomatous germ cell tumours (NSGCTs) and to indicate important clinical tation were alive after 3, 12, 34 and 47 months. The only patient with isolated brain relapse died within observations. Patients and methods Between 1990 and 1996, 167 7 months, despite combined treatment. Two of the five patients who developed brain metastases during patients with metastatic NSGCT were treated in our department; 11 had brain metastases (eight with the course of the disease are alive with no evidence of disease at 3 and 6 months after salvage chemotherapy. solitary metastases and three with multiple lesions, mean age 27 years, range 18-41). These patients Conclusion Patients with single brain metastasis seem to have a better prognosis in the present than in other were treated initially with either; cisplatin, bleomycin, etoposide and/or cisplatin, vincristin, methotrexate, reported series. Chemotherapy was used initially, followed by surgery and radiotherapy in those who did bleomycin, actinomycin-D, cyclophosphamide, etoposide and intrathecal methotrexate chemotherapy pronot achieve complete remission with chemotherapy.Patients with progressive disease and multiple brain tocols. Six patients received chemotherapy alone, one had chemotherapy plus radiotherapy and four had all metastasis do not seem to benefit from initial surgical resection. Importantly, a significant proportion (32%) three treatments. Patients with brain metastases were classified according to mode of presentation, and their of patients with bulky lung metastases had or subsequently developed brain metastases. Thus it is sugtreatments and outcomes analysed. Results Ten patients presented with symptoms related gested that routine cranial imaging should be performed in patients with bulky thoracic disease. to intracranial lesions, e.g. intractable headache, seizures, severe vomiting, hallucinations and hemiparesis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The management of brain metastasis in nonseminomatous germ cell tumours

et al. 1999

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“…Whereas cerebral metastases at presentation are described in almost all large series of chemo-therapy-treated testicular cancer, only 16 cases of isolated CNS relapse have been documented in the English language literature [6,8,[14][15][16][17]. An additional six cases have been described in this paper.…”

Section: Discussionmentioning

confidence: 90%

Central nervous system as sanctuary site of relapse in patients treated with chemotherapy for metastatic testicular cancer

Gerl

Clemm²,

Kohl

et al. 1994

Clin Exp Metast

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Isolated central nervous system relapse in patients treated successfully with cisplatin-based chemotherapy for testicular cancer has been described infrequently. In a retrospective analysis we identified this complication in six of 417 patients. Five of the six patients had advanced pulmonary dissemination at onset of chemotherapy, and post-chemotherapy surgery did not reveal viable tumour tissue in any of these cases. All six patients developed a single cerebral metastasis during complete remission a median four months after discontinuation of chemotherapy. Five patients were treated with surgery and subsequent radiotherapy, one patient with irradiation alone. Three patients are alive relapse-free 19, 62 and 86 months after diagnosis of cerebral relapse. One patient was alive with cerebral disease for 12 months without evidence of systemic recurrence. Our data demonstrate that the brain may act as a sanctuary site in chemotherapy-treated testicular cancer. A review of the literature shows that an isolated cerebral relapse is an extremely rare complication, but carries a relatively favourable prognosis.

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“…Anhand des eigenen Patientengutes sollen Klinik, Prognose und Therapie der Hirnabsiedlungen dargestellt werden. (9,17,24,27).…”

Section: Testicular Tumours -Brain Metastasesunclassified