Chemotherapy of Metastatic Seminoma: the Southeastern Cancer Study Group Experience
Overview
Affiliations
From 1978 to 1984, 62 patients with advanced seminoma of testicular or extragonadal origin were entered on two consecutive Southeastern Cancer Study Group (SECSG) protocols. All patients had progressive disease and were stratified according to tumor burden. Randomization on SEG 78-GU240 was cisplatin, vinblastine, and bleomycin (PVB), with or without doxorubicin; on SEG 81-GU332, randomization was to PVB or cisplatin, etoposide (VP-16), and bleomycin (PVP16B). Dosages of etoposide, vinblastine, and doxorubicin were decreased by 25% in patients who had received prior radiotherapy. Thirty patients (55%) had received prior chest and/or abdominal radiotherapy. Overall, 41 of 60 evaluable patients (68%) achieved a complete remission (CR) and 37 patients are alive and free of disease. CR was obtained in 13 of 15 patients (87%) with minimal disease, 13 of 16 (81%) with moderate disease, and 15 of 29 (52%) with advanced disease. Patients with no prior radiotherapy or limited-field (chest or abdomen) radiotherapy were more likely to achieve CR than those with prior chest and abdominal radiotherapy (75% v. 42%). Using univariate analysis, the extent of disease is the only significant prognostic factor, whereas both extent of disease and extent of prior radiotherapy are significant in a multivariate analysis. This study confirms the chemosensitivity of metastatic seminoma in a cooperative group setting and defines prognostic factors useful for comparison of other chemotherapeutic trials in seminoma.
Chew T, Tan H, Raja Othman R, Karppaya S, Thevarajah S, Yeap B Ann Med Surg (Lond). 2021; 72:103112.
PMID: 34888046 PMC: 8636769. DOI: 10.1016/j.amsu.2021.103112.
Ocal N, Yildiz B, Karadurmus N, Dogan D, Ozaydin S, Ocal R Onco Targets Ther. 2016; 9:7445-7450.
PMID: 28003760 PMC: 5158173. DOI: 10.2147/OTT.S107899.
Advances in the treatment of testicular cancer.
Kopp H, Kuczyk M, Classen J, Stenzl A, Kanz L, Mayer F Drugs. 2006; 66(5):641-59.
PMID: 16620142 DOI: 10.2165/00003495-200666050-00005.
Diagnosis and treatment of patients with testicular germ cell cancer.
Hartmann J, Kanz L, Bokemeyer C Drugs. 1999; 58(2):257-81.
PMID: 10473019 DOI: 10.2165/00003495-199958020-00004.
Primary mediastinal seminoma. Efficacy of chemo-radiotherapy alone.
Osada H, Kojima K, YAMATE N Jpn J Thorac Cardiovasc Surg. 1998; 46(9):810-4.
PMID: 9796278 DOI: 10.1007/BF03217827.