Is there a role for high-dose chemotherapy in a patient with metastatic choriocarcinoma with brain-only recurrence within two years of diagnosis after prior treatment with first and second line chemotherapy (BEP x4 and VIP x3)?  

This is the type of patient who would likely benefit from direct or indirect consultation with a high volume center, which most such centers are happy to provide. It is unlikely that his CNS therapy to date, which may or may not provide long term CNS control, will not likely permanently prevent syst...