Chemotherapy of disseminated testicular cancer--a Singapore experience

Eighteen patients with bulky Stage II B or disseminated germinal neoplasms of the testis were treated with 4 months induction chemotherapy regimen of vinblastine, bleomycin and cis-diamminedichloroplatinum since July 1980. Subsequent maintenance therapy for responding patients consisted of monthly vinblastine and bleomycin. The duration of maintenance therapy was 10 months. Twelve patients (66%) entered into complete remission while 4 patients (22%) were partial responders. VP 16-213 (Etoposide) was added to the regimen for those partial and nonresponders. However there was a high percentage (66%) of relapse at 1 year. Major toxicities were severe gastrointestinal toxicities and mild myelosuppression. There was no drug related death. Problems encountered with this programme were compliance of patients, high costs of drugs and short-lived duration of complete remission. It can be concluded that disseminated germinal cells tumours of testis is highly responsive to combination chemotherapy containing cis-platinum, bleomycin and vinblastine.