[Modified chemotherapy regimens in selected testicular cancer patients with good prognosis]

The goal of our study was to assess the feasibility of usage of chemotherapy regimens with reduced intensity in subgroups of selected patients with good-prognosis metastatic nonseminomatous germ cell tumor (NSGCT) of the testis. 18 patients with low-volume stage II NSGCT who achieved normal tumor marker level after the first cycle of cisplatin, etoposide and bleomycin (BEP) chemotherapy (group 1) received etoposide and cisplatin (EP) as second and third cycles of treatment and 15 testicular cancer patients with serological disease only (group 2) underwent three cycles of EP chemotherapy. The chemotherapy-related side effects observed in these patients were compared with those in control group consisting of 93 good-prognosis metastatic patients treated with three standard cycles of BEP. All patients from both groups achieved complete response with chemotherapy alone (14 group 1 and 15 group 2 patients) or by subsequent resection of teratoma or necrosis (4 cases from group 1). No relapse with viable malignancy was observed after the treatment. All the patients remained free of disease during the median follow-up period of 97 and 48 months for groups 1 and 2 respectively. Compared to the control group, less number of treatment cycles was associated with grade III-IV leucopenia in groups 1 (p=0.07) and 2 (p=0.03). Reduced intensity chemotherapy regimens showed efficacy equal to the standard treatment and can be considered as less toxic therapeutic options in these selected patients.