Platinum-based Chemotherapy in Primary Advanced Seminoma—a Retrospective Analysis: Treatment Results at the Northern Israel Oncology Center (1989-2010)

Abstract

Objective:Over the past 30 years, great strides have been made in the treatment of disseminated testicular tumors. Despite the low number of patients and the rarity of studies concerning primary advanced seminoma, the efficacy of chemotherapy is clear, mainly 3–4-cisplatin-based chemotherapy. Aiming to contribute to the understanding and implementation of proper chemotherapeutic management in advanced seminoma patients, we retrospectively summarized our experience with 26 patients who were referred for platinum-based chemotherapy, post-orchiectomy to the Northern Israel Oncology Center between 1989 and 2010. Response rate, side effects, and long-term outcome were investigated.Methods:Before chemotherapy, meticulous staging was done, including tumor markers (B-human chorionic gonadotropin (B-HCG), alpha-fetoprotein (AFP), and lactic dehydrogenase (LDH)), and abdominal and pelvic computerized tomography (CT) scans were carried out.Results:All 26 treated patients achieved complete remission, clinically and symptomatically, with normalization of their CT scans. At a median follow-up of 120 months (range, 24–268 months) all patients are alive, without evidence of recurrent disease. One patient whose disease recurred twice achieved a third complete remission following salvage treatment with high-dose chemotherapy and autologous peripheral stem cell transplantation. Another patient, who preferred surveillance, relapsed abdominally after 9 months but achieved long-standing complete remission with cisplatin-based chemotherapy. Both these patients are alive with no evidence of disease. Three patients recovered uneventfully from bleomycin-induced pneumonitis.Conclusions:Advanced seminoma is a highly curable disease using platinum-based chemotherapy. Our study confirms the efficacy and safety of cisplatin-based chemotherapy in the treatment of advanced seminoma.

Investigating the Frequency of the ERCC1 Gene C8092A Polymorphism in Iranian Patients with Advanced Gastric Cancer

“…rs3212986, rs11615, C118T and C8092A polymorphisms affect ERCC1 mRNA expression, and subsequently clinical outcome of cisplatin chemotherapy (Stein et al, 2014). About in vitro studies, resistance to platinum associated with the expression levels of ERCC1 mRNA in ovary (Steffensen et al, 2014), testis (Schettino et al, 2008), bladder and lung cancers (NSCLC) (Qin et al, 2014) were studied and the existence of this relationship in patients with chronic gastric, ovarian, colon, esophagus and NSCLC cancer were confirmed (Schettino et al, 2008).…”