High-Dose Busulfan and Thiotepa Followed by Autologous Stem Cell Transplantation for Refractory Choriocarcinoma with Central Nervous System Metastases: A Case Report

Introduction

Choriocarcinoma is particularly challenging to treat when it has metastasized to the central nervous system. Although metastatic choriocarcinoma generally responds well to therapy, brain metastases are associated with markedly poorer survival and can lead to severe neurological complications. One of the main challenges is that standard chemotherapy regimens, such as high-dose platinum derivatives and etoposide, do not effectively cross the blood-brain barrier, preventing adequate control in the central nervous system. For many, often relatively young patients, treatment options become severely limited when radiotherapy is contraindicated or has already been administered and surgery is not feasible.