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Four cycles of BEP versus an alternating regime of PVB and BEP in patients with poor-prognosis metastatic testicular non-seminoma; a randomised study of the EORTC Genitourinary Tract Cancer Cooperative Group.
Four cycles of BEP versus an alternating regime of PVB and BEP in patients with poor-prognosis metastatic testicular non-seminoma; a randomised study of the EORTC Genitourinary Tract Cancer Cooperative Group.
- Source :
-
British journal of cancer [Br J Cancer] 1995 Jun; Vol. 71 (6), pp. 1311-4. - Publication Year :
- 1995
-
Abstract
- We have investigated whether an alternating induction chemotherapy regimen of PVB/BEP is superior to BEP in patients with poor-prognosis testicular non-seminoma. A total of 234 eligible patients were randomised to receive an alternating schedule of PVB/BEP for a total of four cycles or four cycles of BEP. Poor prognosis was defined as any of the following: lymph node metastases larger than 5 cm, lung metastases more than four in number or larger than 2 cm, haematogenic spread outside the lungs, such as in liver and bone, human chorionic gonadotrophin > 10,000 IU l-1 or alphafetoprotein > 1000 IU l-1. The complete response (CR) rates to PVB/BEP and BEP were similar, 76% and 72% respectively (P = 0.58). In addition, there was no significant difference in relapse rate, disease-free and overall survival at an average follow-up of 6 years. The 5-year progression-free and survival rates in both treatment groups were approximately 80%. The PVB/BEP regime was more toxic with regard to bone marrow function; the frequencies of leucocytes below 1000 microliters-1, leucocytopenic fever and platelets below 25,000 microliters-1, throughout four cycles were 28% vs 5% (P < 0.001), 16% vs 5% (P = 0.006), and 10% vs 1% (P = 0.001) respectively. Neuropathy also occurred more often in the PVB/BEP arm: 47% vs 25% (P = 0.001). This study shows that an alternating regimen of PVB/BEP is not superior to BEP and that it is more myelo- and neurotoxic.
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols adverse effects
Bleomycin administration & dosage
Bone Neoplasms drug therapy
Bone Neoplasms secondary
Cisplatin administration & dosage
Disease-Free Survival
Drug Administration Schedule
Etoposide administration & dosage
Follow-Up Studies
Humans
Liver Neoplasms drug therapy
Liver Neoplasms secondary
Lung Neoplasms drug therapy
Lung Neoplasms secondary
Lymphatic Metastasis
Male
Prognosis
Survival Rate
Testicular Neoplasms mortality
Testicular Neoplasms pathology
Time Factors
Vinblastine administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Testicular Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0007-0920
- Volume :
- 71
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- British journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 7540039
- Full Text :
- https://doi.org/10.1038/bjc.1995.254