Two cycles of etoposide/cisplatin cured all patients with stage I testicular seminoma: risk-adapted protocol of the Hellenic Cooperative Oncology Group.

Abstract

OBJECTIVES:

Adjuvant carboplatin is used as adjuvant therapy in Stage I testicular seminoma. Although cure is the rule, relapses still occur, especially in high-risk populations. We report the results of a risk-adapted strategy by the Hellenic Cooperative Oncology Group.

METHODS:

From 1996 to 2003, 64 patients with Stage I seminoma and one of two risk factors (maximal tumor diameter greater than 4 cm and/or age younger than 34 years) were prospectively included in a protocol of adjuvant chemotherapy. Treatment consisted of two 3-week courses of etoposide 120 mg/m2 and cisplatin 40 mg/m2 for three consecutive days with granulocyte colony-stimulating factor support.

RESULTS:

Of the 64 patients, 43 (67%) were younger than 34 years and 55 (86%) had a tumor diameter greater than 4 cm. Neutropenia and nausea and vomiting were the most frequent grade 3 or 4 toxicities (16.5% and 9.5%, respectively), apart from alopecia. After a median follow-up of 60 months (range 7 to 118), no disease relapses have occurred. A metachronous testicular carcinoma has been reported. One patient died of causes unrelated to his disease.

CONCLUSIONS:

The results of our study have shown that two cycles of etoposide and cisplatin is an effective and safe form of adjuvant therapy for Stage I testicular seminoma. Risk factors can be used to identify patients who could benefit from etoposide and cisplatin treatment.

• Authors: Aristotelis Bamias, Gerassimos Aravantinos, Charalambos Deliveliotis, Anastasios Thanos, George Klouvas, Nikolaos Antoniou, Iraklis Poulias, Thomas Makatsoris, Epaminondas Samantas, Meletios A Dimopoulos
• Journal: Urology (Urology) Vol. 70 Issue 6 Pg. 1179-83 (Dec 2007) ISSN: 1527-9995 [Electronic] United States
• PMID: 18158042 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)

Chemical References

• Etoposide
• Cisplatin

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Chemotherapy, Adjuvant
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Drug Administration Schedule
• Etoposide (administration & dosage)
• Humans
• Male
• Orchiectomy
• Seminoma (drug therapy, pathology)
• Testicular Neoplasms (drug therapy, pathology)