Metastatic Seminoma: Should Treatment Be Different from Non-seminoma?

  • J. Ong
  • R. T. D. Oliver
  • J. Shamash
  • M. Williams
  • B. Sizer
  • J. Ostrowski
  • J. Le Vay
Conference paper

Abstract

It is now more than 50 years since Friedman [1] first demonstrated that seminoma was more sensitive to radiation than non-seminoma and it has since been standard to give a different radiation dosage. In contrast, although our group first demonstrated 18 years ago that the chemosensitivity of metastatic seminoma to single agent cisplatin was so different to that of non-seminoma, that it might be safe to treat all metastatic seminoma with single agent and only use combination to salvage the minority who fail it [2, 3], BEP combination chemotherapy remains the standard of care. With new evidence from multivariate analysis demonstrating that pure seminoma histology predicts for a better relapse free survival after cisplatin based combination therapy than non-seminoma [4] and given the increased anxiety about late second malignant events after etoposide treatment [5], renewed interest in this issue is emerging. This paper updates the results from our studies and attempts to define a subgroup of seminoma patients in whom it may be safe to use single agent platinum therapy.

Keywords

Toxicity Platinum Etoposide Carboplatin Oxaliplatin 

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Copyright information

© Springer-Verlag London Limited 2002

Authors and Affiliations

  • J. Ong
    • 1
  • R. T. D. Oliver
    • 1
  • J. Shamash
    • 1
  • M. Williams
    • 1
  • B. Sizer
    • 1
  • J. Ostrowski
    • 1
  • J. Le Vay
    • 1
  1. 1.St Bart’s and London, Oldchurch, Addenbrookes ColchesterNorfolk & Norwich, and Ipswich HospitalsUK

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