Einhorn et al developed a prognostic score for a male with a metastatic germ cell tumor. This can help identify a patient who may benefit from high-dose chemotherapy with stem-cell rescue. The authors are from Indiana University.
Salvage chemotherapeutic regimen:
(1) carboplatin and etoposide
(2) subsequent infusion of autologous peripheral blood hematopoietic stem cells
Parameters:
(1) use of the high dose chemotherapy regimen
(2) response to previous platinum-based therapy
(3) IGCCCG prognostic group at diagnosis
Parameter
Finding
Points
chemotherapy regimen
second line
0
third line or after
3
response to previous platinum-based therapy
responsive
0
refractory
2
initial IGCCCG group
low or intermediate risk
0
high risk
2
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the worse the prognosis.
Total Score
Risk Group
5 Year Survival
0
low
82%
2 or 3
intermediate
63%
4, 5 or 7
high
38%
where:
• There are no combinations for 1 or 6 points.
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