TY - JOUR
T1 - Paclitaxel-based high-dose chemotherapy with autologous stem cell rescue for relapsed germ cell tumor
T2 - Clinical outcome and quality of life in long-term survivors
AU - Pal, Sumanta K.
AU - Yamzon, Jonathan
AU - Sun, Virginia
AU - Carmichael, Courtney
AU - Saikia, Junmi
AU - Ferrell, Betty
AU - Frankel, Paul
AU - Hsu, Joann
AU - Twardowski, Przemyslaw
AU - Stein, Cy A.
AU - Margolin, Kim
N1 - Funding Information:
Dr Pal's efforts are supported by the NIH Loan Repayment Plan (LRP) and NIH , K12 2K12CA001727-16A1 .
PY - 2013/6
Y1 - 2013/6
N2 - Background: High-dose chemotherapy (HDCT) is a viable and potentially curative approach for patients with relapsed or refractory germ cell tumors (GCTs). However, no comparative data exist to define the optimal chemotherapeutic strategy, and little is known about the quality of life (QOL) of long-term survivors. Herein we attempt to characterize the QOL in long-term survivors who received high-dose paclitaxel, etoposide, carboplatin, and ifosfamide (TECTIC). Patients and Methods: Details of the TECTIC regimen and clinical outcomes for the initial 33 patients have been reported. In the present study, we report the clinical data for 15 additional patients. Using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and the Functional Assessment of Cancer Therapy-Taxane (FACT-T) questionnaires, we surveyed all patients who survived at least 4 years after HDCT. Results: Forty-eight patients were enrolled and 46 patients received protocol therapy. For all 48 patients, the median progression-free survival (PFS) and overall survival (OS) were 11.8 months (range, 5.8-not reached) and 21.7 months (range, 12.7-not reached), respectively. Seventeen patients were progression free at a median of 123.2 months (51.6-170.2 months), and 6 patients remain alive after progression with a median OS of 68.8 months (47.6-147.1 months). Of the 23 surviving patients, 18 were accessible and consented to telephone interviews. Compared with historical cohorts, survivors had a higher global health scale score (87.04 vs. 75.62; P =.02) but a lower physical functioning score (68.89 vs. 92.66; P =.0001) by the QLQ-C30 scale. Conclusions: HDCT with the TECTIC regimen produces durable remissions in patients with relapsed or refractory GCTs with acceptable QOL in long-term survivors.
AB - Background: High-dose chemotherapy (HDCT) is a viable and potentially curative approach for patients with relapsed or refractory germ cell tumors (GCTs). However, no comparative data exist to define the optimal chemotherapeutic strategy, and little is known about the quality of life (QOL) of long-term survivors. Herein we attempt to characterize the QOL in long-term survivors who received high-dose paclitaxel, etoposide, carboplatin, and ifosfamide (TECTIC). Patients and Methods: Details of the TECTIC regimen and clinical outcomes for the initial 33 patients have been reported. In the present study, we report the clinical data for 15 additional patients. Using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and the Functional Assessment of Cancer Therapy-Taxane (FACT-T) questionnaires, we surveyed all patients who survived at least 4 years after HDCT. Results: Forty-eight patients were enrolled and 46 patients received protocol therapy. For all 48 patients, the median progression-free survival (PFS) and overall survival (OS) were 11.8 months (range, 5.8-not reached) and 21.7 months (range, 12.7-not reached), respectively. Seventeen patients were progression free at a median of 123.2 months (51.6-170.2 months), and 6 patients remain alive after progression with a median OS of 68.8 months (47.6-147.1 months). Of the 23 surviving patients, 18 were accessible and consented to telephone interviews. Compared with historical cohorts, survivors had a higher global health scale score (87.04 vs. 75.62; P =.02) but a lower physical functioning score (68.89 vs. 92.66; P =.0001) by the QLQ-C30 scale. Conclusions: HDCT with the TECTIC regimen produces durable remissions in patients with relapsed or refractory GCTs with acceptable QOL in long-term survivors.
KW - Autologous transplant
KW - Germ cell tumors
KW - High-dose chemotherapy
KW - Paclitaxel
KW - Quality of life
KW - TECTIC
KW - Testicular cancer
UR - http://www.scopus.com/inward/record.url?scp=84876975132&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876975132&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2012.09.007
DO - 10.1016/j.clgc.2012.09.007
M3 - Article
C2 - 23062817
AN - SCOPUS:84876975132
SN - 1558-7673
VL - 11
SP - 121
EP - 127
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 2
ER -