The activity of single-agent carboplatin in advanced seminoma

Abstract

Between 1982 and 1990, 70 patients with advanced metastatic seminoma were treated with 4–6 courses of single-agent carboplatin (SAC) administered at 400 mg/m 2 every 3–4 weeks. Treatment was of low toxicity and no patients suffered neurotoxicity, ototoxicity or significant renal damage. There was only one episode of neutropenic sepsis and no thrombocytopenic bleeding. The median follow-up of surviving patients was 3 years. 16 patients have relapsed and 4 of these 16 have died, thus the actuarial 3-year relapse-free survival was 77% (95% CI 65–86%), cause-specific survival was 94% (95% CI 82–99%) and overall survival was 91% (95% CI 80–96%). The risk of relapse was reduced by post-chemotherapy irradiation (PCRT) to involved nodes, occurring in 1 20 patients treated with PCRT compared with 11 31 who could have been treated but were not ( P = 0.04). Of the 16 patients who relapsed, 12(75%) have been salvaged with combination chemotherapy and remain free from further relapse with a median follow-up of 18 months. Though this level of survival is equivalent to that obtained with initial cisplatin-based combination chemotherapy, the recurrence rate indicates that SAC remains an investigative treatment, except for unfit patients.