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Successful treatment of good-risk disseminated testicular cancer with cisplatin, bleomycin, and reduced-dose vinblastine.

Abstract
Cisplatin, vinblastine and bleomycin (PVB) is very effective therapy in disseminated testicular cancer, but toxicity is severe. A further reduction of vinblastine might reduce the acute toxicity of PVB without compromising the response rate in good-risk patients. Starting in March 1982, 42 consecutive patients with minimal or intermediate advanced disease (lymph node metastases less than 10 cm, lung nodules less than 5 cm) began a 0.2-mg/kg vinblastine PVB regimen, provided that serum alpha-fetoprotein (AFP) levels were not greater than 1000 ng/ml and human chorionic gonadotropin (HCG) values were not greater than 50,000 mIU/ml. Only 9 patients (21.4%) had leukocyte counts less than 1000/mm3, 6 (14%) had infections, but none had documented sepsis. Gastrointestinal and neuromuscular toxicities were mild. Of the 42 patients, 41 (97.6%) entered complete remission (CR), 8 with surgery. After a median follow-up period of 26 months (range, 19-40 months), 35 patients (83.3%) are continuously disease-free. Of the 6 patients with AFP levels greater than 400 ng/ml and/or HCG values greater than 1000 mIU/ml, only 2 (33.3%) entered continuous CR, versus 33 (91.6%) of the 36 patients with normal or less elevated markers (P less than 0.01). PVB with a 0.2-mg/kg vinblastine dosage is very effective and well-tolerated therapy in selected good-risk patients with disseminated germinal testis cancer.
AuthorsG Pizzocardo, R Salvioni, F Zanoni, A Milani, L Piva
JournalCancer (Cancer) Vol. 57 Issue 11 Pg. 2114-8 (Jun 01 1986) ISSN: 0008-543X [Print] United States
PMID2421865 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Chorionic Gonadotropin
  • alpha-Fetoproteins
  • Bleomycin
  • Vinblastine
  • Cisplatin
Topics
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Bleomycin (administration & dosage)
  • Chorionic Gonadotropin (blood)
  • Cisplatin (administration & dosage)
  • Drug Administration Schedule
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Testicular Neoplasms (drug therapy)
  • Vinblastine (administration & dosage)
  • alpha-Fetoproteins (analysis)

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