[Chemotherapy alternatives, problems and outlook in testicular tumors]

The treatment of testicular tumors is among the most impressive examples of progress in tumor chemotherapy. At present, a complete remission can be achieved with the world-wide adopted standard therapy Cisplatinum/Vinblastine/Bleomycin in 50-80% of the cases. Whether these remissions are equivalent to healing remains to be established in long-term studies; at any rate, they are long-term palliations. Main problems of further research are the high-risk patients. Approaches to reach complete remissions and thus long-term palliations or healing, consist in increase of combination, dose escalation with Cisplatinum, introduction of novel substances (Etoposide, Ifosfamide etc.). The latter field is scientifically underdeveloped, as is the field of second- and third-order therapy. After all, chemotherapy of testicular tumors--similarly as treatment of leukemia--is an oncological intensive therapy that should be restricted to specialized centers.