Reduced dose PVB treatment of stage IIC-IV testicular seminoma.

From 1984 to 1989, 354 patients with a diagnosis of testis tumor were referred to the Oncology Hospital, Ankara, Turkey, for therapy. Thirty-six patients with testicular seminoma in Stages IIC-IV of disease were treated with reduced dose PVB combination chemotherapy consisting of cisplatin (20 mg/m2 for 5 consecutive days), vinblastine (20 mg on day 2) and bleomycin (15 mg on days 2, 9, 16). Nineteen patients had Stage IIC, seventeen had Stage IV. Histologic diagnoses were typical seminoma in 33 patients, anaplastic seminoma in two patients and spermatocytic seminoma in only one patient. Human chorionic gonadotropin (HCG) levels were elevated in 19 patients, alpha-fetoprotein (AFP) levels were normal. Fifteen of thirty-six patients had prior radiotherapy. Two of thirty-six patients refused therapy after two cycles and the other one refused therapy after one cycle. Of the remaining 33 patients, 32 reached complete remission (CR) (96.9%). No relapse has occurred. Reduced dose PVB chemotherapy can be successfully and safely used as the primary treatment of choice in patients with Stage IIC-IV testicular seminoma.