Onkologie
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Febrile neutropenia/leukopenia (FN/FL) is the most frequent dose-limiting toxicity of myelosuppressive chemotherapy, but German data on economic consequences are limited. ⋯ FN/FL treatment has economic relevance for hospitals. Costs vary between tumour types, being significantly higher for LPD compared to PBC patients. The impact of clinical characteristics on asymmetrically distributed costs needs further evaluation.
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Carboplatin dosing in children is based on renal function and there exists a wealth of formulae available for calculating the body surface area (BSA), the glomerular filtration rate (GFR), and the carboplatin dose. ⋯ The choice of the GFR formula is more important for the carboplatin dose calculation compared to the BSA or dose equation. GFR calculations in children show marked, age-dependent variations. A sequence of multiple calculation steps (especially for the Schwartz and Marina formulae) may lead to considerable uncertainty and proneness to error in the clinical routine. In high-risk patients, GFR should be measured precisely and complemented by therapeutic drug monitoring.
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In relapsed germ cell tumors, salvage chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) is a well-established regimen for patients with favorable features such as a primary testicular tumor and prior complete remission (CR) after the initial chemotherapy. We reviewed patients who had received salvage TIP chemotherapy, and evaluated the efficacy of TIP, linking it to patient characteristics. ⋯ Even in the presence of poor prognostic features, salvage TIP chemotherapy can be an active regimen in patients with relapsed or refractory germ cell tumors.