Cisplatin, vinblastine and bleocin in the treatment of disseminated testicular cancer

Abstract

Fifty-nine stage IV disseminated testicular cancer patients underwent 5 or more courses of cisplatin, vinblastine and bleocin (PVB) chemotherapy from August 1981 to July 1989. Tumour histology included 15 seminomas, 13 embryonal carcinomas, 13 teratocarcinomas and 18 mixed tumours. Thirty-four patients (58%) achieved complete remission with an average duration of 56+ months (range 3 to 113+), and 12 patients (20%) achieved partial remission with an average duration of 8.5 months (range 2 to 33). The overall response rate was 78%. Four patients achieved complete remission after adjunctive surgery. The best response was obtained in seminoma patients (73% complete remission). The 5-year survival is 88% for complete responders, 10% for partial responders, and 53% overall. The PVB combination has considerably improved the survival of disseminated testicular cancer patients, but the low survival rate in poor-risk patients necessitates more aggressive chemotherapy regimens.