The changing role of chemotherapy in treatment of non-seminomatous germinal testicular cancer.

Although this series is too small for meaningful statistical conclusions it demonstrates the effectiveness and hazards of bleomycin and vinblastine combined with other treatment modalities in the handling of non-seminomatous germinal testicular cancer. Bleomycin and vinblastine therapy is indicated 1) as a last restor in patients who have failed with other forms of therapy, 2) to convert high stage lesions to a lower stage and 3) as adjuvant therapy in the lowest stage lesions. The indications, risks and alternatives to chemotherapy, especially in patients with low stage tumors, must be realized by the physician and patient prior to its administration. However, the results reported here and elsewhere are so encouraging that we strongly recommend more aggressive use of these agents in any treatment regimen involving non-seminomatous tumors.