PTU - Polskie Towarzystwo Urologiczne
list of articles:

Chemotherapy of non-seminoma testicular tumors
Article published in Urologia Polska 2007/60/3.

authors

Adam Płużański
Klinika Chemioterapii Uniwersytetu Medycznego w Łodzi

keywords

testis, testicular non-seminoma, chemotherapy

summary

Standard management options in early stages of nonseminomatous germ cell tumors have not changed significantly and the cure rate is nearly 100%. The cure rates of both - retroperitoneal lymph node dissection (RPLND) and chemotherapy in stage I, reach 100%. PET and MRI are not superior to the CT in initial diagnosis. The effi-cacy of surgery and chemotherapy in stage II seems to be equal. In advanced GCT three cy-cles of BEP (bleomycin, etoposide, cisplatin) cure approximately 90% of good prognosis pa-tients, classified according to International Germ Cell Cancer Collaborative Group. In patients with poor prognosis GCT, less than 50% achieve a long-term complete response. After resec-tion of residual masses, if viable cancer is found, two courses of consolidation chemotherapy should be considered. Standard therapy for the relapse is cisplatin and ifosfamide, in combina-tion with vinblastine (VIP) or etoposide (VeIP), which provides long-term complete response in 25% of patients with 3-year survival rate of 53%. The response rates to the newgeneration treatment regimens achieve 46%. A high-dose chemotherapy in patients with unfavorable prognostic features and patients requiring third-line therapy results in a long-term complete remission in 20% of patients. The studies suggest the correlation between the level of experi-ence of treating institution and the long-term clinical outcome of the patients. The hormonal abnormalities and the risk of infertility define the individual management in every stage of the disease. Relapse of GCT or the resistance to first line chemotherapy remain the unsolved problem. The superiority of any new chemotherapy salvage-regimen over another cisplatincontaining salvage regimen has not been demonstrated so far.

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correspondence

Adam Płużański
Klinika Chemioterapii Nowotworów
ul. Paderewskiego 4
93-509 ŁódĽ
tel. (042) 689 54 30
apluz@mp.pl