Treatment of disseminated non-seminomatous testicular cancer: The European experience

Wit, Ronald de

doi:10.1002/(sici)1098-2388(199912)17:4<250::aid-ssu5>3.0.co;2-m

Cited by 12 publications

(1 citation statement)

References 25 publications

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“…Variables associated with treatment outcome were identified. Using these prognostic factors clinical trials have focused on attempts either to decrease the toxicity of the standard therapy in patients with a high possibility of cure, or to improve the outcome by intensifying therapy in patients with adverse risk factors [3].…”

Section: Introductionmentioning

confidence: 99%

Management of good risk germ‐cell tumours

Troost¹,

Sternberg²,

Wit³

2009

BJU International

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chemotherapy in good-risk disease has been reduced from four cycles of BEP (4BEP) to three cycles of BEP (3BEP). Four cycles of etoposide and cisplatin (4EP) is an alternative treatment regimen, with similar efficacy. Studies that explored additional adjustments in the BEP regimen to further decrease toxicity have shown that the lower threshold of efficacy has been reached, and that the efficacy of the chemotherapy is compromised. Especially during the last decade, important long-term side-effects after the treatment of germ-cell cancers have been recognized. Chemotherapy in patients with germ-cell cancer increases the risk of developing cardiovascular disease and second malignant neoplasms. Whether 3BEP or 4EP is the optimal chemotherapy regimen for the future remains to be identified. Possibly differences in acute and late toxicities attributed to chemotherapy might eventually identify the best strategy.

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Section: Introductionmentioning

confidence: 99%

Management of good risk germ‐cell tumours

Troost¹,

Sternberg²,

Wit³

2009

BJU International

Self Cite

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Platinum exposure and cause‐specific mortality among patients with testicular cancer

Groot

Leeuwen

Lubberts

et al. 2019

Cancer

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BACKGROUND: Although testicular cancer (TC) treatment has been associated with severe late morbidities, including second malignant neoplasms (SMNs) and ischemic heart disease (IHD), cause-specific excess mortality has been rarely studied among patients treated in the platinum era. METHODS: In a large, multicenter cohort including 6042 patients with TC treated between 1976 and 2006, causespecific mortality was compared with general population mortality rates. Associations with treatment were assessed with proportional hazards analysis. RESULTS: With a median follow-up of 17.6 years, 800 patients died; 40.3% of these patients died because of TC. The cumulative mortality was 9.6% (95% confidence interval [CI], 8.5%-10.7%) 25 years after TC treatment. In comparison with general population mortality rates, patients with nonseminoma experienced 2.0 to 11.6 times elevated mortality from lung, stomach, pancreatic, rectal, and kidney cancers, soft-tissue sarcomas, and leukemia; 1.9-fold increased mortality (95% CI, 1.3-2.8) from IHD; and 3.9-fold increased mortality (95% CI, 1.5-8.4) from pneumonia. Seminoma patients experienced 2.5 to 4.6 times increased mortality from stomach, pancreatic, bladder cancer and leukemia. Radiotherapy and chemotherapy were associated with 2.1 (95% CI, 1.8-2.5) and 2.5 times higher SMN mortality (95% CI, 2.0-3.1), respectively, in comparison with the general population. In a multivariable analysis, patients treated with platinum-containing chemotherapy had a 2.5-fold increased hazard ratio (HR; 95% CI, 1.8-3.5) for SMN mortality in comparison with patients without platinum-containing chemotherapy. The HR for SMN mortality increased 0.29 (95% CI, 0.19-0.39) per 100 mg/m 2 platinum dose administered (P trend < .001). IHD mortality was increased 2.1-fold (95% CI, 1.5-4.2) after platinum-containing chemotherapy in comparison with patients without platinum exposure. CONCLUSIONS: Platinum-containing chemotherapy is associated with a dosedependent increase in the risk of SMN mortality. Cancer 2020;126:628-639.

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The EORTC Genito-Urinary Tract Cancer Group

Bono

Zurlo

2002

European Journal of Cancer

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Treatment of disseminated non-seminomatous testicular cancer: The European experience

Cited by 12 publications

References 25 publications

Management of good risk germ‐cell tumours

Management of good risk germ‐cell tumours

Platinum exposure and cause‐specific mortality among patients with testicular cancer

The EORTC Genito-Urinary Tract Cancer Group

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