title: The activity of single-agent carboplatin in advanced seminoma.
abstract: Between 1982 and 1990, 70 patients with advanced metastatic seminoma were treated with 4-6 courses of single-agent carboplatin (SAC) administered at 400 mg/m2 every 3-4 weeks. Treatment was of low toxicity and no patients suffered neurotoxicity, ototoxicity or significant renal damage. There was only one episode of neutropenic sepsis and no thrombocytopenic bleeding. The median follow-up of surviving patients was 3 years. 16 patients have relapsed and 4 of these 16 have died, thus the actuarial 3-year relapse-free survival was 77% (95% CI 65-86%), cause-specific survival was 94% (95% CI 82-99%) and overall survival was 91% (95% CI 80-96%). The risk of relapse was reduced by post-chemotherapy irradiation (PCRT) to involved nodes, occurring in 1/20 patients treated with PCRT compared with 11/31 who could have been treated but were not (P = 0.04). Of the 16 patients who relapsed, 12(75%) have been salvaged with combination chemotherapy and remain free from further relapse with a median follow-up of 18 months. Though this level of survival is equivalent to that obtained with initial cisplatin-based combination chemotherapy, the recurrence rate indicates that SAC remains an investigative treatment, except for unfit patients.
authors.affiliation: Unit of Radiotherapy and Oncology, Royal Marsden Hospital, Sutton, Surrey, U.K.
authors.forename: A
authors.initials: A
authors.lastname: Horwich
authors.forename: D P
authors.initials: DP
authors.lastname: Dearnaley
authors.forename: R
authors.initials: R
authors.lastname: A'Hern
authors.forename: M
authors.initials: M
authors.lastname: Mason
authors.forename: G
authors.initials: G
authors.lastname: Thomas
authors.forename: G
authors.initials: G
authors.lastname: Jay
authors.forename: J
authors.initials: J
authors.lastname: Nicholls
mesh_terms: D000328:Adult; D000368:Aged; D016190:Carboplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004407:Dysgerminoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D016190:Carboplatin