Disseminated seminoma: re-evaluation of treatment protocols

Radiotherapy provides a high cure rate for patients with stages I and II seminoma but the results for those with stage III disease have been disappointing. We report on 19 patients with high stage seminoma who have been treated with platinum, vinblastine and bleomycin (14 patients) or platinum, vinblastine, bleomycin and doxorubicin hydrochloride (5 patients). Of the 19 patients 12 (63 per cent) had complete remission of the disease and the remaining 7 had partial remission. To date, 11 patients (58 per cent) remain free of disease. Of the 6 patients with no prior irradiation 5 achieved complete remission, while the 1 failure had massive hepatic metastases. The median followup was 19 months (range 12 to 37 months). These results parallel that achieved with the same chemotherapy regimen in patients with stage III nonseminomatous testicular cancer.