The efficiency of a tetraploid hybrid from H. bulbosum x H. vulgare as the pollinator in hybridization with varieties from T. aestivum (5), T. turgidum (3), triticale (2) and S. cereale (1) was ...tested. The chromosomal constitutions of the hybrid genotypes were revealed by 11 isoenzyme markers (ER, AAT, EST, NDH, PGM, MDH, PER, 6‐PGDH, LAP, NAD‐AADH, and NADP‐AADH) of all 7 barley chromosomes (without distinguishability between H. bulbosum and H. vulgare) and cytologically studied by checking the chromosome number in mitosis and meiosis. Hybrid plant production of pollinated florets (in percent) ranged from 0.0 (triticale and rye) to 27.0 (T. aestivum). Incomplete elimination of barley chromosomes occurred in crosses with T. aestivum. The degree of elimination varied with the wheat genotype and accounted for up to a maximum of 30 % of produced hybrid plants. The other plants were eu‐ or hypohaploid wheats (e.g., lacking chromosome 1B or 3A). Isoenzyme analysis of plants of the first backcross generation with wheat marked, in single plants, the meiotic transmission of added barley chromosomes from primary hybrids. Usability of this system of crossing the tetraploid H. bulbosum x H. vulgare hybrid with wheat is discussed with regard to genetic introgression and haploid production in wheat.
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Objectives: We developed the first German evidence- and
consensus-based clinical guideline on diagnosis, treatment,
and follow-up of germ cell tumours (GCT) of the testes in
adult patients. We ...present the guideline content in 2 separate publications. The present second part summarizes the
recommendations for the treatment of advanced disease
stages and for the management of follow-up and late effects.
Materials and Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the
guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review
questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. Results: Here we present
the treatment recommendations separately for patients
with metastatic seminoma and non-seminomatous GCT
(stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex
cord/stromal tumours, the management of follow-up and
toxicity, quality-of-life aspects, palliative care, and supportive therapy. Conclusion: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present
guideline. The guideline also comprises quality indicators for
measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented
in a future publication
Abstract
Introduction: This is the first German evidence- and consensus-based clinical guideline on diagnosis, treatment,
and follow-up on germ cell tumours (GCTs) of the testis in
adult patients. We ...present the guideline content in two
publications. Part I covers the topic’s background, methods, epidemiology, classification systems, diagnostics,
prognosis, and treatment recommendations for the localized stages. Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the
guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review
questions, which were based on systematic literature
searches (last search was in March 2018) were provided.
Thirty-one experts entitled to vote, rated the final clinical
recommendations and statements. Results: We provide
161 clinical recommendations and statements. We present
information on the quality of cancer care and epidemiology
and give recommendations for staging and classification as
well as for diagnostic procedures. The diagnostic recommendations encompass measures for assessing the primary tumour as well as procedures for the detection of metastases. One chapter addresses prognostic factors. In part I,
we separately present the treatment recommendations for
germ cell neoplasia in situ, and the organ-confined stages
(clinical stage I) of both seminoma and nonseminoma. Conclusion: Although GCT is a rare tumour entity with excellent
survival rates for the localized stages, its management requires an interdisciplinary approach, including several clinical experts. Quality of care is highly related to institutional
expertise and can be reassured by established online-based
second-opinion boards. There are very few studies on diagnostics with good level of evidence. Treatment of metastatic GCTs must be tailored to the risk according to the International Germ Cell Cancer Collaboration Group classification after careful diagnostic evaluation. An interdisciplinary
approach as well as the referral of selected patients to centres with proven experience can help achieve favourable
clinical outcomes.
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