Salvage therapy after relapse
Therapeutic approach for patients with recurrent SYST was not
homogeneous. Therapeutic strategies were developed based on the response
to the previous treatment. The salvage strategy consisted of
platinum-based chemotherapy basically followed by resection of residual
masses when possible. External-beam irradiation was performed in
patients with recurrent local relapse at the dose of 50 Gy. Oral
cyclophosphamide (CTX) and vinorelbine (NVB)-containing maintenance
regimens or VP16 alone were administered to repeated relapsed patients
with inoperable residual disease after salvage chemotherapy or residual
disease after resection. Schedule was as following: CTX 50
mg/m2, d1-28; NVB 25 mg/m2, on days
1, 8, 15 or oral etoposide 50 mg/m2, d1-14, two weeks
break meaning two weeks on and two weeks off. Each cycle of treatment
was repeated every 4 weeks.