Multimodale Therapiekonzepte von Keimzelltumoren

TY - JOUR

T1 - Multimodale Therapiekonzepte von Keimzelltumoren

AU - Honecker, F

AU - Souchon, R

AU - Krege, S

AU - Bokemeyer, C

PY - 2010/11/1

Y1 - 2010/11/1

N2 - The management of patients with germ cell tumors must be based upon complete staging and should be risk-adapted. Seminoma stage I can be managed by either active surveillance, adjuvant carboplatin therapy, or radiotherapy. Seminoma stage IIA should receive radiotherapy, stage IIB can be managed with either radiotherapy or chemotherapy. Seminoma stage IIC and III are treated with three (to four) cycles of PEB (cisplatin, etoposide, bleomycin). Nonseminoma stage I should be managed by either active surveillance or adjuvant chemotherapy with one (to two) cycles of PEB, based upon the risk factor vascular invasion. Treatment of advanced nonseminoma consists of either 3 or 4 cycles of PEB and must be guided by the IGCCCG prognostic subgroup. Prognosis is particularly poor in patients with either primary mediastinal nonseminoma, and/or metastases to liver, brain or bone, or inadequate tumor marker decline. In these cases, intensification of therapy with high dose chemotherapy can be justified. Complex cases with poor prognosis and all patients with relapsed disease should exclusively be treated by experts in a tertiary care setting to achieve highest possible cure rates in these young patients.

AB - The management of patients with germ cell tumors must be based upon complete staging and should be risk-adapted. Seminoma stage I can be managed by either active surveillance, adjuvant carboplatin therapy, or radiotherapy. Seminoma stage IIA should receive radiotherapy, stage IIB can be managed with either radiotherapy or chemotherapy. Seminoma stage IIC and III are treated with three (to four) cycles of PEB (cisplatin, etoposide, bleomycin). Nonseminoma stage I should be managed by either active surveillance or adjuvant chemotherapy with one (to two) cycles of PEB, based upon the risk factor vascular invasion. Treatment of advanced nonseminoma consists of either 3 or 4 cycles of PEB and must be guided by the IGCCCG prognostic subgroup. Prognosis is particularly poor in patients with either primary mediastinal nonseminoma, and/or metastases to liver, brain or bone, or inadequate tumor marker decline. In these cases, intensification of therapy with high dose chemotherapy can be justified. Complex cases with poor prognosis and all patients with relapsed disease should exclusively be treated by experts in a tertiary care setting to achieve highest possible cure rates in these young patients.

KW - Combined Modality Therapy

KW - Cooperative Behavior

KW - Humans

KW - Interdisciplinary Communication

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - Neoplasm, Residual

KW - Neoplasms, Germ Cell and Embryonal

KW - Patient Care Team

KW - Prognosis

KW - Seminoma

KW - Tumor Markers, Biological

U2 - 10.1007/s00108-010-2675-5

DO - 10.1007/s00108-010-2675-5

M3 - SCORING: Zeitschriftenaufsatz

C2 - 20938625

VL - 51

SP - 1382

EP - 1387

JO - INTERNIST

JF - INTERNIST

SN - 0020-9554

IS - 11

ER -