Patterns of relapse in poor-prognosis germ-cell tumours in the GETUG 13 trial: Implications for assessment of brain metastases.
Eur J Cancer
; 87: 140-146, 2017 12.
Article
in En
| MEDLINE
| ID: mdl-29149760
ABSTRACT
BACKGROUND:
The GETUG 13 phase III trial tested personalised chemotherapy based on tumour marker decline in patients with poor-prognosis germ-cell tumour (GCT) and demonstrated that a dose-dense regimen improves progression-free survival in patients with an unfavourable decline. We investigated the pattern of relapse for patients included in GETUG 13.METHODS:
We conducted an analysis of relapse events in patients from GETUG 13. Baseline procedures before inclusion in the trial comprised a thoraco-abdomino-pelvic computed tomography scan and a magnetic resonance imaging of the brain.RESULTS:
With a median follow-up of 4.1 years (0.3; 8.8 years), a progression event was observed in 109/254 patients (43%). First event consisted in a marker progression only in 47 patients (43%), a radiographic progression only in 35 patients (32%), a mix progression on both markers and imaging in 12 patients (11%) and death in 15 patients (14%). In patients with radiographic progression only, brain was the predominant site (nâ¯=â¯19/35, 54%). Among patients with unfavourable decline who experienced a radiographic progression (as first and subsequent progression event, nâ¯=â¯58), brain was a site of progression in 28 patients (48%) 12/30 (40%) in patients treated with cisplatin, bleomycin and etoposide and 16/28 (57%) in those treated with dose-dense chemotherapy.CONCLUSIONS:
Brain metastases develop often, early and frequently as the only site of relapse in the course of poor-prognosis GCT. This raises the question of early detection and optimal treatment of brain metastases in these patients, e.g. by integrating a systematic brain MRI after 2-3 months of chemotherapy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Testicular Neoplasms
/
Brain Neoplasms
/
Antineoplastic Combined Chemotherapy Protocols
/
Neoplasms, Germ Cell and Embryonal
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Humans
/
Male
Country/Region as subject:
America do norte
/
Europa
Language:
En
Journal:
Eur J Cancer
Year:
2017
Document type:
Article