ISSN:
1569-8041
Keywords:
chemotherapy
;
germ cell tumour
;
non-seminomatous
;
teratoma
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: An alternating combination chemotherapy schedule for advancednonseminomatous germ cell tumours (NSGCT) has been in use since 1977. Patients and methods: Three hundred thirty-nine men with metastatic NSGCTwere treated with POMB/ACE (cisplatin, vincristine, methotrexate, bleomycin,actinomycin D, cyclophosphamide and etoposide), including 42 who had receivedprevious chemotherapy or radiotherapy. Previously untreated patients wereclassified according to the International Germ Cell Cancer Collaborative Group(IGCCCG) model, and 31% were in the worst prognostic group. Results: The median follow-up is eight years. The overall survival at fiveyears is 82% (95% confidence interval (CI);78%–85%). The survival of untreated patients exceeded thatfor previously treated patients (log-rank P = 0.04) and of testicular tumoursexceeded that for primary extragonadal tumours (log-rank P 〈 0.0001). Thesurvival of men with IGCCCG poor prognosis disease at three years is75% (95% CI: 65%–84%) compared to 50%in the large cohort which was used to derive the model. There were five earlytreatment related deaths. In addition, five patients developed acuteleukaemia, one developed a second primary lung adenocarcinoma, one man diedof pulmonary fibrosis and three men died of cerebrovascular or cardiovasculardisease. Conclusions: The POMB/ACE schedule has been employed in a large series ofmen with metastatic NSGCT over two decades. The fatal toxicity is equivalentto that described for simpler regimens. It yields equivalent response ratesand survival in men with good prognosis disease and appears to achieve bettersurvival in patients with poor prognosis disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008279222625
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