Highdose chemotherapy

In a Phase II study of 235 patients treated with ECF, 10% survival at four years was observed. One way to attempt to increase the proportion of long-term survivors is to use high-dose chemotherapy as consolidation in patients achieving a partial or complete remission. A previous study observed an 89% partial remission rate with high-dose etoposide and cisplatin. The lack of complete response was probably due to the fact that patients were not cyto-reduced with conventional chemotherapy prior to high-dose therapy. A randomized study is underway in patients who achieve complete or partial remission at 12 weeks, with randomization to high-dose carboplatin/etoposide with peripheral stem cell transplant or to continuation of initial treatment.

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