peplomycin and Germinoma

The advent of cisplatin rendered disseminated testicular germ cell tumor an often curable malignant disease. Patients with a heavy metastatic burden, however, remain poor risks; furthermore, many patients experience nausea or other adverse events. This paper reports a trial of a cisplatin-based (COMPE) combination chemotherapy regimen based on synchronization theory.. Twenty patients with disseminated germ cell testicular tumors were treated with COMPE; any residual tumor mass was surgically resected.. Seventeen patients (85%) achieved complete remission by chemotherapy. The actuarial overall and cause-specific 3-year survival rates were 89% and 94%, respectively. In the subset of 16 "good-risk" patients, all remain alive after a median follow-up of 43 months. Complications were quite tolerable, with nephrotoxicity in particular being extremely mild.. COMPE is an effective chemotherapy regimen in patients with disseminated germ cell testicular tumors. Complications arising from this therapy are mild.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Child, Preschool; Cisplatin; Etoposide; Germinoma; Humans; Male; Methotrexate; Middle Aged; Peplomycin; Survival Analysis; Testicular Neoplasms; Treatment Outcome; Vincristine

Since 1989, 4 patients with Stage III nonseminomatous germ cell tumor of the testis underwent thoracotomy for persistent radiographic masses after systemic chemotherapy. They were treated with multi-drug regimen including cisplatin, vincristine, methotrexate, peplomycin, and etoposide until normalization of tumor markers was obtained. Residual masses of the 4 patients consisted of viable cancer cells in 1 patient, immature teratoma in 1, mature teratoma in 1 and necrosis in 1. Of the 4 patients 3 achieved complete remission and are doing well with no evidence of disease, while the other case with residual viable cancer cells died of renal failure. The key to successful treatment of advanced testicular cancer was considered to be a favorable response to chemotherapy and complete resection of any residual tumors.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Chemotherapy, Adjuvant; Cisplatin; Drug Administration Schedule; Etoposide; Germinoma; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Methotrexate; Peplomycin; Testicular Neoplasms; Thoracotomy; Vincristine