Intensive and timely chemotherapy, the key of success in testicular cancer

More than 90%, of patients with advanced germ cell tumors (GCT) are curable since the introduction of cisplatin-based chemotherapy, but only half of t hem with poor-risk characteristics and less than a quarter after the first relapse are cured by conventional chemotherapy. In this review, we have stu died the results of dose-intensity in conventional chemotherapy and high-do se chemotherapy (HDCT) in the treatment of GCT patients. In first line, onl y one randomized trial of HDCT was performed and no benefit was demonstrate d. One US randomized trial is ongoing. In first salvage treatment, no rando mized trial was performed, and a European trial (IT94) is ongoing. In the r efractory situation, there is no indication of high-dose chemotherapy. in c onclusion, high-dose chemotherapy is not a standard treatment for different situations. New strategies are needed to improve the survival rate of poor prognosis germ cell tumor patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.