[The modification of the toxicity produced by chemotherapy in testicular cancer by adapting its intensity to prognostic groups].
BACKGROUND
The reduction of iatrogenesis is fundamental in the treatment of germ-cell testicular tumors (GTT) because of the high incidence of cures achieved. On the other hand, the tumoral mass and the serum concentration of the beta fraction of the gonadotropin hormone (CGH) and of alphafetoprotein allow the differentiation of 2 clear prognostic groups; those for which the intensity of chemotherapy may be adapted to reduce its collateral effects and improve the results.


METHODS
In the Oncology Department of the Hospital de la Santa Creu i Sant Pau 23 patients with GTT of good prognosis were treated between 1984-1990. These patients were given the combination of etoposide-cisplatin (EP) over the same period. Twenty patients with a bad prognosis received the alternative scheme of bleomycin-vincristine-methotrexate-cisplatin/etoposide-cisplatin- phosphamide (BOMP/EPI).


RESULTS
In comparison to the classical treatment with cisplatin-vinblastine-bleomycin (PVB) the EP association demonstrated less iatrogenesis except in regards to the formation of granulocytopenia which was higher. The BOM/EPI combination conditioned greater hematological toxicity during the acute phase and the first observations suggested a diminution of chronic iatrogenesis.


CONCLUSIONS
These results indicate that chemotherapy in testicular cancer may be adapted to the aggressiveness of the with the aim to thereby reduce global toxicity.
Blanco Guerrero
R
R
Servicio de Oncología, Hospital de la Santa Creu i Sant Pau, Barcelona.
Germà Lluch
J R
JR
Climent Durán
M A
MA
Mercedes Ramírez
A
A
Alonso Muñoz
C
C
López Pousa
A
A
López López
J J
JJ
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D001761:Bleomycin; D016685:Mitomycin; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide
Modificación de la toxicidad producida por la quimioterapia en el cáncer de testículo al adecuar su intensidad a los grupos pronósticos.