title: Two cycles of etoposide/cisplatin cured all patients with stage I testicular seminoma: risk-adapted protocol of the Hellenic Cooperative Oncology Group.
abstract: OBJECTIVE
  Adjuvant carboplatin is used as adjuvant therapy in Stage I testicular seminoma. Although cure is the rule, relapses still occur, especially in high-risk populations. We report the results of a risk-adapted strategy by the Hellenic Cooperative Oncology Group.
  
  
  METHODS
  From 1996 to 2003, 64 patients with Stage I seminoma and one of two risk factors (maximal tumor diameter greater than 4 cm and/or age younger than 34 years) were prospectively included in a protocol of adjuvant chemotherapy. Treatment consisted of two 3-week courses of etoposide 120 mg/m2 and cisplatin 40 mg/m2 for three consecutive days with granulocyte colony-stimulating factor support.
  
  
  RESULTS
  Of the 64 patients, 43 (67%) were younger than 34 years and 55 (86%) had a tumor diameter greater than 4 cm. Neutropenia and nausea and vomiting were the most frequent grade 3 or 4 toxicities (16.5% and 9.5%, respectively), apart from alopecia. After a median follow-up of 60 months (range 7 to 118), no disease relapses have occurred. A metachronous testicular carcinoma has been reported. One patient died of causes unrelated to his disease.
  
  
  CONCLUSIONS
  The results of our study have shown that two cycles of etoposide and cisplatin is an effective and safe form of adjuvant therapy for Stage I testicular seminoma. Risk factors can be used to identify patients who could benefit from etoposide and cisplatin treatment.
authors.affiliation: Department of Clinical Therapeutics, University of Athens Medical School, Athens, Greece. abamias@med.uoa.gr
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Bamias
authors.forename: Gerassimos
authors.initials: G
authors.lastname: Aravantinos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Thanos
authors.forename: George
authors.initials: G
authors.lastname: Klouvas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Antoniou
authors.forename: Iraklis
authors.initials: I
authors.lastname: Poulias
authors.forename: Thomas
authors.initials: T
authors.lastname: Makatsoris
authors.forename: Epaminondas
authors.initials: E
authors.lastname: Samantas
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009919:Orchiectomy; D018239:Seminoma / Q000188:drug therapy* / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D005047:Etoposide; D002945:Cisplatin