Metastatic Seminoma: Should Treatment Be Different from Non-seminoma?
It is now more than 50 years since Friedman  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  and given the increased anxiety about late second malignant events after etoposide treatment , 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.
KeywordsRelapse Free Survival Etoposide Treatment Good Risk Patient Single Agent Carboplatin Malignant Event
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