Skip to main content
SpringerLink
Log in

Sequentiell alternierende Chemotherapie nicht-seminomatöser Hodentumoren mit Velbe/Bleomycin und Adriamycin/Cisplatin

II. Langzeit-Ergebnisse einer Studie bei 140 Patienten mit retroperitonealer Metastasierung (Stadium II)

Sequential combination chemotherapy with vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum (II) in non-seminomatous testicular cancer

II. Long-term results of a study with 140 patients with retroperitoneal disease (stage II)

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

Following orchiectomy and retroperitoneal lymph node dissection (RND) 140 patients with stage II non-seminomatous testicular cancer were treated by sequential combination chemotherapy consisting of vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum(II) (DDP), plus/minus radiotherapy. 68 stage IIA-patients (complete RND and normal tumor-markers thereafter) received 6 courses of chemotherapy, followed by radiotherapy in 35 patients. 40 stage IIB-patients (minor residual disease after RND or elevated tumor-markers after RND) and 32 stage IIC-patients (advanced residual disease after RND) were treated by at least 12 chemotherapy courses and optional intermittent radiotherapy and/or relaparotomy. In stage IIA and IIB disease the actuarial 4-year survival rates were between 80 and 100%. These favourable results were not significantly influenced by additional radiotherapy and corresponded to the survival rates for 34 stage I-patients. For stage IIC-patients the prognosis was significantly worse with a 12% 4-year survival rate.

Zusammenfassung

Seit 1975 wurden 140 Patienten mit retroperitoneal-metastasierten nicht-seminomatösen Hodentumoren nach Orchiektomie und retroperitonealer Lymphadenektomie sequentiell alternierend mit den Zytostatika-Kombinationen Velbe/Bleomycin und Adriamycin/Cisplatin plus/minus Radiotherapie behandelt. Davon erhielten 68 Patienten nach totaler retroperitonealer Lymphadenektomie mit postoperativ normalisierten Tumormarkern (Stadium IIA) 6 Chemotherapie-Kurse, woran sich bei 35 Patienten eine Strahlentherapie anschloß. Vierzig Patienten wurden nach subtotaler retroperitonealer Lymphadenektomie oder bei postoperativ erhöhten Tumormarkern (Stadium IIB) und 32 Patienten nach palliativer Lymphadenektomie (Stadium IIC) mit mindestens 12 Chemotherapie-Kursen und fakultativer intermittierender Radiotherapie und/oder Relaparotomie behandelt. Der Vergleich der Behandlungsergebnisse bei den Stadien IIA und IIB ergab unabhängig von der zusätzlichen Radiotherapie nach der „Life-table“-Methode Vier-Jahres-Überlebensraten zwischen 80 und 100%. Diese günstigen Resultate sind mit den Ergebnissen bei 34 nicht adjuvant behandelten Patienten ohne histologisch nachweisbare retroperitoneale Metastasierung (Stadium I) vergleichbar. Ausdruck einer statistisch signifikant schlechteren Prognose bei fortgeschrittener retroperitonealer Metastasierung ist eine Vier-Jahres-Überlebensrate von 12% bei den Patienten im Stadium IIC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  1. Brehmer B, Lehmann G, Mellin P (1978) Wertigkeit der Lymphographie bei Patienten mit teratoiden Hodentumoren. Radiologie 18:76–79

    Google Scholar 

  2. Carter SK (1979) A perspective on adjuvant chemotherapy of testicular cancer. J Cancer Res Clin Oncol 95:1–9

    Google Scholar 

  3. Cutler SJ, Ederer F (1958) Maximum utilization of the life table method in analyzing survival. J Chron Dis 8:699–712

    Google Scholar 

  4. Dewys WD (1979) Basis for adjuvant chemotherapy for stage II testicular cancer. Cancer Treat Rep 63:1693–1695

    Google Scholar 

  5. Dixon FJ, Moore RA (1953) Testicular tumors: A clinicopathological study. Cancer 6:427–454

    Google Scholar 

  6. Donohue JP, Einhorn LH, Perez JM (1978) Improved management of nonseminomatous testis tumors. Cancer 42:2903–2908

    Google Scholar 

  7. Earle JD, Bagshaw MA, Kaplan HS (1973) Supervoltage radiation therapy of the testicular tumors. Am J Roentgen 117:653–661

    Google Scholar 

  8. Einhorn LH, Donohue J (1977) cis-Diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Int Med 87:293–298

    Google Scholar 

  9. Höffken K, Schmidt CG (1977) Klassifizierung und Stadieneinteilung der Hodentumoren. Dtsch Med Wochenschr 102:249–252

    Google Scholar 

  10. Hussey DH, Luk KH, Johnson DE (1977) The role of radiation therapy in the treatment of germinal cell tumors of the testis other than pure seminoma. Radiology 123:175–180

    Google Scholar 

  11. Javadpour N (1979) Applications of biologic tumor markers in testicular cancer. Cancer Treat Rep 63:1643–1647

    Google Scholar 

  12. Javadpour N (1979) Staging procedures and the role of surgery in testicular cancer. Cancer Treat Rep 63:1637–1641

    Google Scholar 

  13. Kaufmann H (1966) Ein einfaches Verfahren zur Auswertung von Überlebenskurven bei tödlich verlaufenden Erkrankungen. Strahlentherapie 130:509–527

    Google Scholar 

  14. Leiter E, Brendler H (1967) Loss of ejaculation following bilateral retroperitoneal lymphadenectomy. J Urol 98:375–378

    Google Scholar 

  15. Lynch DF Jr, McCord LP, Nicholson TC, Richie JP, Sargents CR (1978) Sandwich therapy in testis tumor: Current experience. J Urol 119:612–613

    Google Scholar 

  16. Maier JG, Mittemeyer B (1977) Carcinoma of the testis. Cancer 39:981–986

    Google Scholar 

  17. Peckham MJ (1979) An appraisal of the role of radiation therapy in the management of nonseminomatous germ-cell tumors of the testis in the era of effective chemotherapy. Cancer Treat Rep 63:1653–1658

    Google Scholar 

  18. Peckham MJ, McElwain TJ, Barrett A, Hendry WF (1979) Combined management of malignant teratoma of the testis. Lancet 2:267–270

    Google Scholar 

  19. Samuels ML, Johnson DE, Brown B, Bracken RB, Morgan ME, Eschenbach A von (1979) Velban plus continuous infusion bleomycin (VB-3) in stage III advanced testicular cancer: Results in 99 patients with a note on high-dose velban and sequential cis-platinum. In: Johnson DS, Samuels ME (eds). Cancer of the Genitourinary Tract. Raven Press, New York, pp 159–172

    Google Scholar 

  20. Scheulen ME, Higi M, Pfeiffer R, Schmidt CG (1979) The importance of continuous control of AFP, βHCG, and LDH in the course of testicular cancer. Seventh Meeting of International Society for Oncodevelopmental Biology and Medicine, Surrey, UK, 9.–14.9.1979

  21. Scheulen ME, Higi M, Schilcher RB, Meier CR, Seeber S, Schmidt CG (1980) Sequentiell alternierende Chemotherapie nicht-seminomatöser Hodentumoren mit Velbe/Bleomycin und Adriamycin/Cisplatin. I. Ergebnisse einer randomisierten Studie bei 71 Patienten mit pulmonaler Metastasierung (Stadium IV) Klin Wochenschr 58:811–821

    Google Scholar 

  22. Scheulen ME, Seeber S, Schilcher RB, Hossfeld DK, Schmidt CG (1979) Combination chemotherapy and radiotherapy in stage II nonseminomatous testicular cancer. In: Jones SE, Salmon SE (eds) Adjuvant Therapy of Cancer II. Grune & Stratton, New York, pp 337–344

    Google Scholar 

  23. Scheulen ME, Seeber, S, Schilcher RB, Meier CR, Schmidt CG (1980) Sequential combination chemotherapy with vinblastine (NSC-49842)/bleomycin (NSC-125066) and adriamycin (NSC-123127)/cis-dichlorodiammineplatinum(II) (NSC-119875) in disseminated non-seminomatous testicular cancer. Cancer Treat Rep (im Druck)

  24. Seeber S, Scheulen ME, Osieka R, Höffken K, Schmidt CG (1978) Development of chemotherapy programs containing vinblastine, bleomycin, adriamycin and cisplatin for testicular teratomas: In: Carter SK, Crooke ST, Umezawa H (eds) The Bleomycins — Current Status and New Developments. Academic Press, New York, pp 215–226

    Google Scholar 

  25. Seeber S, Scheulen ME, Schilcher RB, Meier CR, Schmidt CG (1979) Sequential combination chemotherapy with velbanbleomycin and adriamycin-cisplatin in stage III testicular teratomas. Proc Am Ass Cancer Res 20:282

    Google Scholar 

  26. Skinner DG (1976) Non-seminomatous testis tumors: A plan of management based on 96 patients to improve survival in all stages by combined therapeutic modalities. J Urol 115:65–69

    Google Scholar 

  27. Slawson RG (1978) Radiation therapy for germinal tumors of the testis. Cancer 42:2216–2223

    Google Scholar 

  28. Staubitz WJ, Early KS, Magoss IV, Murphy CP (1974) Surgical management of testis tumor. J Urol 111:205–209

    Google Scholar 

  29. Vugrin D, Cvitkovic E, Whitmore W Jr, Golbey RB (1978) Prophylactic chemotherapy of testicular germ cell carcinomas (nonseminomas) stage II following orchiectomy and retroperitoneal dissection. Proc Am Ass Cancer Res & Am Soc Clin Oncol 19:352, ASCO Abstr C-184

    Google Scholar 

  30. Walsh PC, Kaufman JJ, Coulson WF, Goodwin WE (1971) Retroperitoneal lymphadenectomy for testicular tumors. J Am Med Ass 217:309–312

    Google Scholar 

  31. Werf-Messing B van der (1976) Radiotherapeutic treatment of testicular tumors. Int J Rad Oncol Biol Phys 1:235–248

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Westdeutsches Tumorzentrum Essen, Innere Universitätsklinik und Poliklinik (Tumorforschung), Germany

    M. E. Scheulen, W. Bierbaum, N. Niederle, S. Seeber &  C. G. Schmidt

  2. Westdeutsches Tumorzentrum Essen, Urologische Universitätsklinik und Poliklinik, Germany

    H. -U. Eickenberg

  3. Westdeutsches Tumorzentrum Essen, Universitäts-Strahlenklinik des Radiologischen Zentrums, Germany

    H. Holfeld

Authors
  1. M. E. Scheulen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Bierbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Niederle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. -U. Eickenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Holfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Seeber
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. G. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scheulen, M.E., Bierbaum, W., Niederle, N. et al. Sequentiell alternierende Chemotherapie nicht-seminomatöser Hodentumoren mit Velbe/Bleomycin und Adriamycin/Cisplatin. Klin Wochenschr 58, 823–828 (1980). https://doi.org/10.1007/BF01491102

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01491102

Key words

Schlüsselwörter

Search

Navigation