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.