Multimodale Therapiekonzepte von Keimzelltumoren
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Multimodale Therapiekonzepte von Keimzelltumoren. / Honecker, F; Souchon, R; Krege, S; Bokemeyer, C.
In: INTERNIST, Vol. 51, No. 11, 01.11.2010, p. 1382-7.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -