One cycle of bleomycin, etoposide and cisplatin plus two cycles of etopeside and cisplatin chemotherapy in selected patients with low-volume stage II nonseminomatous germ cell tumor of the testis.
OBJECTIVE
To assess the feasibility of bleomycin omission from second and third cycles of bleomycin, etoposide and cisplatin (BEP) chemotherapy in low-volume stage II nonseminomatous germ cell tumor patients who achieve a normal tumor marker level after the first cycle of treatment.


METHODS
Out of 59 nonseminomatous testicular cancer patients with low-volume retroperitoneal disease, serum markers normalized after the first cycle of treatment in 30 cases. 12 patients completed 3BEP (group 1; years 1994-1998) and other 18 patients received etoposide and cisplatin (EP) as second and third cycles of chemotherapy (group 2; years 1998-2004).


RESULTS
All patients from each group achieved complete response with chemotherapy alone or by subsequent resection of teratoma or necrosis. There was no relapse with active cancer after the treatment. All patients remained disease-free during the median follow-up period of 97 and 48 months for groups 1 and 2 respectively.


CONCLUSIONS
One cycle of BEP plus two cycles of EP chemotherapy was as effective as three standard cycles of BEP. The regimen can be suggested as a less toxic therapeutic alternative in these selected patients. More cases, however, in a prospective randomized setting are required to further verify these data.
Mezvrishvili
Zaza
Z
National Centre of Urology, Tbilisi, Georgia. zazamezvrishvili@hotmail.com
Managadze
Laurent
L
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D018450:Disease Progression; D005047:Etoposide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D018239:Seminoma / Q000175:diagnosis; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin