Three cycles of etoposide and cisplatin chemotherapy in clinical stage IS nonseminomatous testicular cancer

Abstract

To assess the efficacy of three cycles of etoposide and cisplatin (EP) chemotherapy in the patients with serological disease only after orchiectomy. Fifteen patients with nonseminomatous germ cell tumors of the testis and elevated serum tumor markers as the only evidence of persistent disease following radical orchiectomy (clinical stage IS cancer), were treated at our institution from March 1995 to February 2003. All patients received three cycles of EP chemotherapy. The toxicity was compared with that in control group consisting of 93 patients treated with three standard cycles of cisplatin, etoposide and bleomycin for good-prognosis metastatic diseases. The markers normalized in all patients after one (in 11 cases) or two (in 4 cases) cycles. One patient required subsequent surgery for recurrent retroperitoneal mature teratoma. All patients remained disease-free during the median follow-up period of 85 months (range: 33-128). In patients receiving EP chemotherapy less number of treatment cycles was associated with grade IV leukopenia compared to control group (p=0.04). A treatment program that consists of three cycles of EP caused complete disease control in all patients. The applied regimen may be considered as a therapeutic option with reduced toxicity in clinical stage IS nonseminomatous testicular cancer patients. More evidence, however, needs to be accumulated.