Table 1.
Summary of studies of super high-risk patients.
| References | Number of patients | Level of hCG IU/L | Pulmonary mts | Other mts | Initial pO2 mmHg | Full dose/reduced dose chemotherapy | Chemotherapeutical regimen | Infection complications no pts. | ARDS/death from ARDS | Hemorhage no pts. | Death due to ARDS/survival |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moran-Ribon et al. (10) | 11 | (9,114–1,080,000) median >100,000 | 8 (73%) | Mediastinal LAP, hilar LAP, kidney, liver, pancreas, adrenal gland | <60 mmHg 9(82%) >60 mmHg 2 (18%) |
11 (100%)–full dose | Different cisplatin-based regimens | 7 (64%) 11 (100%) febrile |
11(100%) | NR | All died |
| Kirch et al. (18) | 16 | (33–413,000) median 81,700 | 9 (56%) | Liver, bones, brain | <70 mmHg 16(100%) <46 mmHg 9(56%) |
16 (100%)–full dose | EP, adriamycin, cyclophosphamide, or adriamycin, cyclophosphamide, vincristine | 5 (31%) 7 (44%) febrile |
9(56%) | 6(38%) | 8/9 (89%) (on MV) died 1/7 (14%) (without MV) died |
| Massard et al. (24) | 25 | (11–8,920,000) median >200,000 | 25 (100%) | NR | <80 mmHg 2(8%) | 15 (60%)–full dose 10 (40%)–reduced EP |
Cisplatin-based regimens-full dose EP-reduced |
NR | 13 (87%_–full dose 3 (30%)–reduced dose |
NR | 9/15 (60%) died–full dose 2/10 (20%) died –reduced dose |
| Gillessen et al. (25) | 20 | (1–1,250,000) median 35,195 | NS, 1 (5%)-massive | RP LAP, stomach, brain, bones | NR | 20 (100%)–reduced-bBOP | bBOP, BEP | NR-no toxic death, no neutropenic sepsis after bBOP | None | 2 (10%) | None died due to ARDS |
| Tryakin et al. (26) | 63 | (0–20,525,000) median >200,000 | 50 (79%) | Liver, mediastinal LAP, RP LAP, brain | NR | 45 (71%)–full dose 18 (29%)–reduced dose |
BEP, EP | Gr.3,4 24 (53%)-full dose vs. 5 (28%) | NR | NR | NR |
NR, non-reported; RP LAP, retroperitoneal lymphadenopathy; BEP, bleomycin, etoposide, cisplatin; EP, etoposide, cisplatin; ARDS, acute respiratory distress syndrome; LAP, lymphadenopathy; bBOP, baby BOP-bleomycin, vincristine, cisplatin; MV, mechanical ventilation.