title: Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma.
abstract: OBJECTIVE
  To retrospectively evaluate the efficacy and toxicity of chemotherapy with cisplatinum, methotrexate and bleomycin (CMB) in the adjuvant and palliative setting, and its effect on survival in patients with locally advanced or metastatic penile carcinoma, which carries a very poor prognosis.
  
  
  METHODS
  Thirteen patients (mean age 54 years) with radically resected local and nodal disease (eight), metastatic disease (two) or metastatic recurrence (three) had chemotherapy with CMB between February 1996 and July 2003. In all, 45 treatment courses were given, with a mean (range) of 3.5 (2-6) courses per patient.
  
  
  RESULTS
  Three of the eight patients with adjuvant treatment showed no evidence of disease after a mean (range) of 54 (41-76) months, while four in this group died from disease progression after a mean of 11 (5-20) months, and one died from treatment-related toxicity. All five patients with metastatic disease died from disease progression after three had shown temporary signs of regression.
  
  
  CONCLUSIONS
  Chemotherapy with CMB had little effect on metastatic penile cancer and responses were transient. However, patients with minimal disease after radical local and lymphatic resection seemed to benefit from adjuvant therapy, but the toxicity was high and carried a risk of death.
authors.affiliation: Department of Urology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany. Oliver.Hakenberg@uniklinikum-dresden.de
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Hakenberg
authors.forename: Johannes B W
authors.initials: JB
authors.lastname: Nippgen
authors.forename: Michael
authors.initials: M
authors.lastname: Froehner
authors.forename: Stefan
authors.initials: S
authors.lastname: Zastrow
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Wirth
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010412:Penile Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001761:Bleomycin; D002945:Cisplatin; D008727:Methotrexate