title: VAB-6 combination chemotherapy in resected stage II-B testis cancer.
abstract: Twenty-four patients with resected Stage II-B nonseminomatous germ cell tumors of the testis received adjuvant chemotherapy with the modified VAB-6 regimen for one year. Eighteen patients had nodal category N2B and six nodal category N3 (extranodal extension of tumor). Adjuvant VAB-6 started with two four day inductions at approximately four week intervals. Induction was cyclophosphamide 600 mg/m2 IV, vinblastine 4 mg/m2 IV, dactinomycin 1 mg/m2 IV, bleomycin 30 mg IV on day 1, then bleomycin 20 mg/m2/day by continuous 24 hour infusion for three days, and cis-platinum 120 mg/m2 IV on day 4. Maintenance was vinblastine 6 mg/m2 IV and dactinomycin 1 mg/m2 IV every three weeks. Six patients received a third induction but without bleomycin. All 24 patients remain free of disease with a median follow up of 24 months. Myelosuppression was the major toxicity. Four patients received antibiotics for fever during myelosuppression. In one patient, serum creatinine temporarily rose over 2 mg/dl after cis-platinum. VAB-6 is effective in the prevention of recurrences in resected Stage II-B nonseminomatous germ cell tumors. However, the optimal regimen remains to be defined.
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001761:Bleomycin / Q000008:administration & dosage / Q000627:therapeutic use; D002699:Chlorambucil / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D003609:Dactinomycin / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000601:surgery; D014747:Vinblastine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001761:Bleomycin; D002699:Chlorambucil; D003609:Dactinomycin; D014747:Vinblastine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin