title: High-dose methotrexate, vincristine and cisplatin as salvage treatment for relapsed non-seminomatous germ-cell cancer.
abstract: Eight patients with non-seminomatous testicular cancer relapsing after primary chemotherapy were treated with salvage chemotherapy consisting of high-dose methotrexate (12 g/m2), vincristine (1.2 mg/m2) weekly for four weeks, followed after an interval of four weeks by 3 times 100 mg/m2 cisplatin (50 mg/m2 on day 1 and 2) every 10 days. This regimen resulted in 2 partial (PR) and 2 complete responses (CR). The two patients achieving CR remain disease-free for 43+ and 53+ months. Toxicity was mainly methotrexate-related and could be ameliorated to a large extent by leucovorin rescue. This small study shows that methotrexate, vincristine, followed by cisplatin is effective in the treatment of relapsed non-seminomatous testicular cancer at the cost of manageable toxicity.
authors.affiliation: Department of Internal Medicine, University Hospital, Groningen, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Sleijfer
authors.forename: W T
authors.initials: WT
authors.lastname: Van der Graaf
authors.forename: P H
authors.initials: PH
authors.lastname: Willemse
authors.forename: E G
authors.initials: EG
authors.lastname: De Vries
authors.forename: H
authors.initials: H
authors.lastname: Schraffordt Koops
authors.forename: N H
authors.initials: NH
authors.lastname: Mulder
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D018237:Germinoma / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000493:pharmacokinetics; D010446:Peptide Fragments / Q000097:blood; D012008:Recurrence; D016879:Salvage Therapy; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D000509:alpha-Fetoproteins; D014750:Vincristine; D002945:Cisplatin; D002955:Leucovorin; D008727:Methotrexate