Annals of Oncology 12:487-491, 2001
© 2001 European Society for Medical Oncology
research-article |
E400P in advanced seminoma of good prognosis according to the International Germ Cell Cancer Collaborative Group (IGCCCG) classification: The Spanish Germ Cell Cancer Group experience
1Hospital Gregorio Marañón Madrid
2Institute Catalan of Oncology Barcelona
3Hospital Sant Joan de Reus
4Hospital La Fe Valencia
5Hospital Sant Pau Barcelona
6Hospital Clínico Universitano Zaragoza
7Hospital Ntra Sra del Mar Barcelona
8Hospital Ntra Sra de Aranzazu San Sebastian, Spain
Correspondence to: Dr J R Germà-Lluch, Institut Catala d' Oncologia, Hospital Duran i Reynals, Avda Gran Via s/n Km 2 7, 08907 Hospitalet de Llobregat, Barcelona, Spain. E-mail jrgerma{at}ico.scs.es
Purpose. To evaluate the efficacy and toxicity of primary chemotherapy with the schedule E400P in the treatment of patients with early stage 11 (IIa and IIb) and advanced seminoma of good prognosis according to the international classification (IGCCCG)
Patients and methods Sixty-four patients were included E400P consisted of cisplatin 25 mg/m2/day and etoposide 100 mg/m2/day for four days, every three weeks Royal Marsden stages were llab 53% and IIc-IV. 47% Twenty-three percent had high BHCG levels, twenty-seven percent had LDH > 2 x N Sixty-two patients were of good prognosis according to the Medical Research Council classification
Results Response rate was 98% (69% complete remission, 29% residual disease). After a median follow-up of 34 months, treatment failure was seen in 7 patients (11%) Neutropenia (32%) was the most relevant grade 3–4 toxicity Other important grade 3–4 side effects were found in less than 5% Three-year time to treatment failure (TTF) was 89% (95%) confidence intervals (CI) 80%–97%) for all patients, 91% (95% CI. 80%–99%) for stages Ila-b, and 87% (95% CI. 74%-99%) for stages IIc-IV Three-year overall survival (OS) was 97% (95% CI 93%–99%) for all patients and 95% (95% CI 85%–99%) for stages Ila-b
Conclusions E400P was a very active and safe regimen in good-prognosis advanced seminoma, with low toxicity rates. Definitive comparisons of this regimen with radiotherapy in stages Ila-b or with the more standard E500P or BEP, could be of interest
advanced seminoma, cisplatin, etoposide, germcell tumour, testicular cancer
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