Cisplatin, etoposide and continuous infusion bleomycin in patients with testicular germ cell tumors: efficacy and toxicity data from a retrospective study

• Published in: Journal of chemotherapy (Florence) Vol. 21; no. 6; p. 687
• Main Authors: Curigliano, G, Spitaleri, G, Magni, E, Lorizzo, K, De Cobelli, O, Locatelli, M, Fumagalli, L, Adamoli, L, Cossu Rocca, M, Verri, E, De Pas, T, Jereczek-Fossa, B, Martinelli, G, Goldhirsch, A, Nolè, F
• Format: Journal Article
• Language: English
• Published: England 01.12.2009
• Subjects: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - administration & dosage; Bleomycin - adverse effects; Cisplatin - administration & dosage; Cisplatin - adverse effects; Combined Modality Therapy; Etoposide - administration & dosage; Etoposide - adverse effects; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - surgery; Orchiectomy; Retrospective Studies; Testicular Neoplasms - drug therapy; Testicular Neoplasms - pathology; Testicular Neoplasms - surgery; Young Adult
• ISSN: 1973-9478
• DOI: 10.1179/joc.2009.21.6.687

We retrospectively reviewed medical charts of 54 patients who underwent orchidectomy for germ cell tumors (GCT) and received a regimen, given every 3 weeks, consisting of cisplatin 100 mg/m2 day 4 intravenous (i.v.), bleomycin 15 Units (U) day 1 i.v. push; bleomycin 10 U days 1-3 24 h i.v. continuous infusion (c.i.) and etoposide 100 mg/m2 days 1-5/i.v. (PEB). 53 of 54 patients achieved a complete remission without adjunctive surgery. At a median follow-up of 48.2 months (95%CI 41.7 - 54.8 months) all patients but one are alive with no evidence of disease recurrence. Patients receiving PEB experienced no pulmonary toxicity, nephrotoxicity nor neurological adverse events. PEB with c.i.bleomycin is an active regimen with a low rate of acute and late toxicity. The main limitations of our study are related to the retrospective analysis, the limited number of patients and the restricted follow-up time. A prolonged follow-up is necessary to evaluate long term toxicity and outcome.