Abstract
Eight patients with non-seminomatous testicular cancer relapsing after primary chemotherapy were treated with salvage chemotherapy consisting of high-dose methotrexate (12 g/m2), vincristine (1.2 mg/m2) weekly for four weeks, followed after an interval of four weeks by 3 times 100 mg/m2 cisplatin (50 mg/m2 on day 1 and 2) every 10 days. This regimen resulted in 2 partial (PR) and 2 complete responses (CR). The two patients achieving CR remain disease-free for 43+ and 53+ months. Toxicity was mainly methotrexate-related and could be ameliorated to a large extent by leucovorin rescue. This small study shows that methotrexate, vincristine, followed by cisplatin is effective in the treatment of relapsed non-seminomatous testicular cancer at the cost of manageable toxicity.
MeSH terms
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Adult
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Chorionic Gonadotropin / blood
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Chorionic Gonadotropin, beta Subunit, Human
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Cisplatin / administration & dosage
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Disease-Free Survival
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Follow-Up Studies
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Germinoma / blood
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Germinoma / drug therapy*
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Germinoma / mortality
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Humans
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Leucovorin / administration & dosage
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Leucovorin / therapeutic use
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Male
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Methotrexate / administration & dosage
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Methotrexate / pharmacokinetics
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Peptide Fragments / blood
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Recurrence
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Salvage Therapy
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Testicular Neoplasms / blood
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Testicular Neoplasms / drug therapy*
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Testicular Neoplasms / mortality
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Time Factors
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Vincristine / administration & dosage
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alpha-Fetoproteins / analysis
Substances
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Chorionic Gonadotropin
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Chorionic Gonadotropin, beta Subunit, Human
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Peptide Fragments
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alpha-Fetoproteins
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Vincristine
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Cisplatin
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Leucovorin
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Methotrexate