Vincristine, cisplatin, and bleomycin with surgery in the management of advanced metastatic nonseminomatous testis tumors.

Most effective treatment regimens for advanced nonseminomatous testis tumors (NSTT) employ vinblastine (V), cisplatin (CDDP), and bleomycin (B) and adjunctive surgery. The toxicity of many of these multidrug programs, primarily from vinblastine-induced myelosuppression has resulted in significant patient morbidity and even death. Since 1978, the authors of this report have used vincristine (VCR), CDDP, and B with adjunctive surgery in patients with advanced NSTT. In the first 29 patients treated with VCR, CDDP, and B and adjunctive surgery, a complete clinical remission (CR) was achieved in 27 (93%) with 3 (11%) recurrences; 24 (83%) remain in CR 18 to 46 months (mean and median of 31 months). Twenty-six (90%) patients had either maximal abdominal tumor (Stage B3) or maximal pulmonary and/or abdominal disease (Stage C). Twenty patients had adjunctive surgery. No patient developed serious chemotoxicity. This treatment regimen is less toxic and equally effective as V, CDDP, and B combinations.