BACKGROUND: Retrospective analysis of characteristics and outcome of germ cell tumour (GCT) patients with cerebral metastases (CM) undergoing high-dose chemotherapy (HD-CTX) or relapsing with CM. PATIENTS AND METHODS: Patients initially presenting with CM (N=50 pts) or at first relapse (n=19 pts) after primary HD-CTX (434 pts) were analysed. RESULTS: Patients with primary CM (N=50) had elevated ss-human chorion gonadotropin (ss-HCG) in 88% and lung metastases in 90%. Eighty six percent responded to HD-CTX and 40% underwent CNS radiotherapy. Forty four percent achieved long-term survival after primary and 16% after salvage treatment (60% in total). All patients relapsing with CM (n=19) presented initially with ss-HCG-elevation and pulmonary metastases. Treatment consisted of CTX in 78%, irradiation in 90% and surgery in 63%. Twenty six percent achieved long-term survival. CONCLUSION: An interdisciplinary approach of HD-CTX, radiotherapy and surgery leads to long-term survival in 60% of patients with CM at initial diagnosis and 26% relapsing with CM.
