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Treating stage I nonseminomatous germ cell tumours with a single cycle of chemotherapy.

Gilbert DC, Norman AR, Nicholl J, Dearnaley DP, Horwich A, Huddart RA

Academic Unit of Radiotherapy & Oncology, Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.

OBJECTIVE: To estimate the rate of relapse in men with stage I nonseminomatous germ cell tumours (NSGCT) of the testis treated with one cycle of chemotherapy instead of the usual two cycles. PATIENTS AND METHODS: Between 1992 and 1996, 22 men with stage I NSGCT who had normalized tumour markers after orchidectomy and negative findings on computed tomography, and who were at moderate risk of relapse, were treated with one cycle of platinum-containing chemotherapy (bleomycin and etoposide with either cisplatin or carboplatin). RESULTS: At a median follow-up of 10.2 years, none of the patients have relapsed with malignant GCTs. CONCLUSION: The results after one cycle of chemotherapy are no worse than after two cycles. The present study needs to be replicated in a larger cohort of patients to define the relapse risk more accurately. This approach is soon to be tested in a large multicentre trial randomizing patients between one and two cycles.

Published 11 July 2006 in BJU Int, 98(1): 67-9.
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