title: Alternating cycles of PVB and BEP in the treatment of patients with advanced seminoma.
abstract: 33 patients (median age 39 years) with advanced seminoma were treated with 4 courses of alternating cisplatin-containing chemotherapy PVB/BEP (cisplatin, vinblastine and bleomycin; bleomycin, etoposide and cisplatin). Patients were classified as stage IIC (n = 7), IID (n = 9), III (n = 13) and IV (n = 4). 8 had had prior radiotherapy; 9 had an elevated beta human chorionic gonadotropin (beta HCG). 30 patients were evaluable for response and 33 for toxicity. During chemotherapy 3 patients died, 1 due to malignant disease, another due to a cardiac arrest, and 1 patient of a bleomycin pneumonitis. 13 (43%) had a complete remission and 17 (57%) had a clinical partial remission (residual radiographic mass). At a median follow-up of 28 months (range 16-88), 3 patients relapsed, 6-8 months after entry. After completion of therapy there were 2 deaths, 1 due to bleomycin pneumonitis and 1 neither tumour nor treatment related. 26 of 33 (79%) patients achieved a continuously disease-free status. Leucocytopenia and thrombocytopenia of WHO grade 3/4 occurred in, respectively, 32/33 (97%) and 20/33 (61%) of the patients. This study shows that alternating PVB/BEP in this group yields comparable response rates with non-alternating schedules but at the expense of considerable toxicity.
authors.affiliation: Department of Internal Medicine, University Hospital, Groningen, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Gietema
authors.forename: P H
authors.initials: PH
authors.lastname: Willemse
authors.forename: N H
authors.initials: NH
authors.lastname: Mulder
authors.forename: J
authors.initials: J
authors.lastname: Oldhoff
authors.forename: E G
authors.initials: EG
authors.lastname: de Vries
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D004407:Dysgerminoma / Q000188:drug therapy* / Q000201:enzymology; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D001761:Bleomycin; D014747:Vinblastine; D005047:Etoposide; D007770:L-Lactate Dehydrogenase; D002945:Cisplatin