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Annals of Oncology 2:197-202, 1991
© 1991 European Society for Medical Oncology

research-article

Original article: Cisplatin, etoposide, ifosfamide, vincristine and bleomycin combination chemotherapy for far advanced testicular carcinoma

A. Harstrick1, H.-J. Schmoll1, C.-H. Köhne-Wömpner1, L. Bergmann2, U. Lammers3, J. Hohnloser4, G. Dölken5, P. Reichhardt6, W. Siegert7, F. Natt8, U. Räth6, H. Wilke1 and H. Poliwoda1

1University of Hannover Hannover
2University of Frankfurt Frankfurt
3University of Münster Münster
4Klinikum Innenstadt München
5University of Freiburg Freiburg
6University of Heidelberg Heidelberg
7Klinikum Charlottenburg University of Berlin
8Hospital Sanderbusch Sanderbusch, Germany

Correspondence to: Dr. A. Harstrick Dept of Hematology and Oncology University of Hannover, Medical School Konstanty-Gutschow-Str. 8 3000 Hannover 61, Germany

Forty-eight patients with advanced testicular cancer, defined as abdominal mass > 10 cm, mediastinal mass >5 cm, more than 20 lung metastases, or visceral organ involvement were treated with an intensive, alternating five-drug regimen consisting of cisplatin 50 mg/m2 d 1–3, etoposide 170 mg/m2 d 1–3, ifosfamide 5 g/m2 d 15, vincristine 2 mg weekly, bleomycin 15 mg/m2 weekly, q d 28. Thirty-four (71%) of the patients attained tumor-free status. This was achieved by chemotherapy alone in 14 patients and by surgical resection of residual disease in the remaining 20 patients (histology of resected tissue: necrosis 12, mature teratoma 7, viable carcinoma 1). Patients with pure seminoma responded better than patients with nonseminoma (CR 100% vs. 67%, respectively). In a univariate analysis only the value of HCG (<vs> 10 000 U/L) and the number of involved organ sites (≤2 vs >2) had significant influence on the response rate. After a minimum follow-up of 24 months 3 patients (9%) have relapsed. The survival rate is 76% after 36 months, with 61% remaining disease-free. Though this intensive regimen might bestow some of the therapeutic advantages of standard three-drug protocols in far advanced testicular cancer, the results are still less than optimal and warrant the exploration of new therapeutic strategies.

testicular cancer, germ cell tumors, cisplatin, etoposide, ifosfamide


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