Abstract
Patients with clinical high-volume disease are candidates for systemic treatment, in both histologic entities, semimona or nonseminomatous germ cell cancer. In general cisplatin, etoposide and bleomycin (PEB) is the recommended polychemotherapy scheme. According to the risk profile either three or four cycles need to be applied. Hematotoxic disorders are frequently reported acute side effects. Nevertheless the risk is still intermediate, so that no granulocyte colony stimulating factor (GCSF) is needed, except in case of previously developed neuropenic fever episodes in order to reduce morbidity in future cycles. The role of high-dose chemotherapy in the primary setting is still unclear and under investigation. High-risk patients with inadequate tumor-marker decline under PEB benefit from an intensivated chemotherapy.
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Pfister, D., Heidenreich, A. (2019). Stage III Germ Cell Cancer. In: Merseburger, A., Burger, M. (eds) Urologic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42623-5_7
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DOI: https://doi.org/10.1007/978-3-319-42623-5_7
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