The role of myeloablative chemotherapy with autologous hematopoietic cell rescue in central nervous system germ cell tumors.

This review of the experience of high dose chemotherapy in patients with recurrent or refractory intracranial germ cell tumor confirms that sustained tumor control can be achieved with this modality both in germinoma and non-germinomatous germ cell tumors. Data from cooperative groups in Europe and North America suggest that the success rate is higher among patients with recurrent germinoma. The role of adjuvant radiation in that context remains unclear. These promising results have led some cooperative groups to incorporate in their protocols a high dose chemotherapy component for newly diagnosed patients with high-risk features or poor response to initial chemotherapy.