title: Possible benefit of doxorubicin treatment in patients with refractory germ cell cancer.
abstract: Forty patients with germ cell cancer (GCC) refractory to vinblastine, cisplatin, and bleomycin therapy were treated with etoposide (E), cisplatin +/- bleomycin +/- doxorubicin and were evaluated retrospectively to determine response to treatment. Thirty cancers were primary testicular and ten extragonadal in origin. Fifty-five percent (22/40 patients) of the group responded to therapy. Eight of 40 (20%) patients had complete responses (CR) and 14 of 40 (35%) had partial responses (PR). Seven of 30 (23%) patients with a testes primary had a CR in contrast to 1 of 10 patients with extragonadal origin cancer. Six of eight patients (75%) having a CR received doxorubicin in combination, while only 2 of 18 (11%) patients having no response were treated with a doxorubicin-combining regimen. Of the entire group, 12 of 14 patients (86%) treated with doxorubicin for the first time responded to therapy compared to 10 to 26 patients (38.5%) not receiving doxorubicin (P = 0.009 Fisher's exact test). Myelosuppression was more frequent in patients treated with doxorubicin (87%) than in those treated without doxorubicin (70%). No increased frequency of hospitalization was required and no treatment-related fatalities occurred. Salvage therapy of patients with GCC appears to be improved when doxorubicin is added to etoposide, cisplatin, and bleomycin.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use*; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D001761:Bleomycin; D005047:Etoposide; D004317:Doxorubicin; D002945:Cisplatin