In this systematic review, across all treatment settings combined, we found a trend toward improved survival outcomes with CDCT compared with HDCT, although these differences did not reach statistical significance across pooled data.
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Systematic Review and Meta-Analysis of the Management of Relapsed Germ Cell Tumours Following Cisplatin-Based Chemotherapy.
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reported a significant improvement in 5-year OS with the addition of radiotherapy to chemotherapy (72% versus 30%, p = 0.004), while the inclusion of surgery showed a trend toward improved survival (5-year OS 62.5% versus 38%), supporting the potential benefit of multimodality treatment in appropriately selected cases [ 78 ].