“…However, results of clinical studies published up to now suggest that standard dose chemotherapy is unable substantially to reduce the testicular relapse rate, independent of the multi-drug schedule employed. In particular, the BFM 76-79 protocol, which is identical to that used for induction by JankaSchaub et al [4], has a testicular relapse rate of 5.6% [5], a figure comparable to that of less aggressive treatments [1,7]. In contrast, intermediate or high-dose MTX has almost abolished testicular relapses both in controlled [2,9] and in uncontrolled studies [3,6] supporting the hypothesis of a testicular sanctuary [10].…”