How would you manage a patient with metastatic testicular cancer, NSGCT who has multiple CNS-only recurrences after prior systemic BEP and TIP?

Patients with advanced metastatic germ cell tumors with CNS recurrences, despite standard dose chemo with BEP and TIP and prior CNS XRT, represent a complicated clinical situation. These patients are almost always patients with either mainly choriocarcinoma or with initial hCG levels >100,000. Fortu...