A modified BEP protocol: reduction of hospitalization without reducing the efficacy

We have aimed at assessing whether a condensed bleomycin/etoposide/cisplatinum (BEP) regimen would be as effective as the conventional protocol in the treatment of patients with metastatic testicular tumors.

Sixty-four consecutive patients with metastatic germ cell testicular tumors were included into this modified BEP protocol between April 1991 and January 1995. The condensed regimen consisted of a single daily dose of cisplatin (100 mg/m2) and bleomycin (30 mg) plus 3 consecutive days of etoposide (150 mg/m2).

Of the 64 patients, 34 (54%) achieved a complete response with chemotherapy alone. An additional 23 (35%) patients in addition to chemotherapy have undergone surgery and became tumor free after resection of the residual masses and additional chemotherapy. The mean hospitalization period of 64 patients who received a total of 289 therapy courses was 65.4 (49-192) h for each course. The creatinine clearances did not differ significantly before and after treatment in neither of the chemotherapy courses.

We would thus like to suggest that this condensed BEP protocol is cost-effective and improves patient compliance and quality of life. Furthermore, this is achieved with comparable efficacy to conventional therapy without increasing the toxicity. However, prospective randomized trials with similar results are needed to determine the efficacy of this regimen, and only then this regimen may replace the conventional therapy.