Non-seminomatous testicular germ cell tumours. Preliminary analysis of ongoing trials in the DATECA Study

This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage I patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients were studied. The overall complete remission rate was 89 per cent including 7 patients who achieved complete remission after secondary surgery. Three patients died from testicular tumours and two toxic deaths occurred in this group. Stage III patients were treated with 6 series of cis-platinum, bleomycin, and vinblastine. Fifty patients were studied. The complete remission rate was 72 per cent including 2 patients who achieved complete remission after secondary surgery. Sixteen patients relapsed after achieving complete remission with a median time to relapse of 4 months. Eight of these died, 4 achieved a new complete remission, while 4 patients are still under treatment. Sixty per cent of the patients are at present alive without evidence of disease, while 12 patients died from testicular tumours and 2 from toxic side effects.