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An alternative treatment regimen of advanced seminoma with carboplatin, etoposide, and bleomycin instead of cisplatin-based therapy.
An alternative treatment regimen of advanced seminoma with carboplatin, etoposide, and bleomycin instead of cisplatin-based therapy.
- Source :
-
Urologic oncology [Urol Oncol] 2013 Jan; Vol. 31 (1), pp. 110-4. Date of Electronic Publication: 2011 Apr 01. - Publication Year :
- 2013
-
Abstract
- Background: Cisplatin-based therapy is associated with acute and late toxicities. Therefore, a potentially less toxic carboplatin-based regimen was evaluated in patients with advanced seminoma.<br />Patients and Methods: Eighteen patients with advanced seminoma were treated on outpatient basis with carboplatin (AUC5) at day 1, etoposide (100 mgm(-2)) at days 1-5, and bleomycin (30 IU) at day 2 (CEB). Treatment was 3-weekly for a total of 4 cycles. Outcome and toxicities were analyzed.<br />Results: Median follow-up was 4 years and 7.5 months. Five-year progression-free survival was 86.6% (95% confidence interval (CI), 70.6%-100%), 5-year overall survival 100%, and 10-year overall survival 85% (95% CI, 63.3%-100%); 39% of all patients reached complete remission. Two patients underwent adjuvant treatment. Two patients relapsed; 1 is in ongoing remission 4 years after salvage therapy, the other died almost 6 years after CEB-therapy, despite multiple lines of salvage therapy. The main acute toxicity observed was hematologic. No late cardiovascular events or secondary malignancies were noted.<br />Conclusion: CEB treatment is effective in advanced seminoma, showing minor toxicity. Progression-free and overall survival rates at 5 and 10 years are comparable to those achieved with cisplatin-based therapy. This indicates that carboplatin-combination therapy might be a good alternative to cisplatin-based therapy in the treatment of advanced seminomas.<br /> (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Bleomycin administration & dosage
Carboplatin administration & dosage
Cisplatin administration & dosage
Etoposide administration & dosage
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local pathology
Neoplasm Staging
Prognosis
Remission Induction
Seminoma mortality
Seminoma pathology
Survival Rate
Testicular Neoplasms mortality
Testicular Neoplasms pathology
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Neoplasm Recurrence, Local drug therapy
Salvage Therapy
Seminoma drug therapy
Testicular Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2496
- Volume :
- 31
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Urologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21458311
- Full Text :
- https://doi.org/10.1016/j.urolonc.2010.10.006