Background: The present study was performed in order to investigate the eff
icacy and safety of high-dose chemotherapy for the treatment of patients wi
th advanced testicular cancer.
Methods: Seven patients were treated with high-dose carboplatin, etoposide
and cyclophosphamide followed by peripheral blood stem cell transplantation
. Five patients received one cycle and two patients received two cycles of
the high-dose chemotherapy.
Results: Of the seven patients, one achieved a complete response and four a
chieved partial responses with markers negative. As a result of subsequent
surgery for residual tumors, three of the four partial responders showed no
residual cancer cells. One patient who did not undergo surgery received ra
diotherapy after the high-dose chemotherapy and the residual tumors disappe
ared. All five patients who had either a complete or partial response are s
till alive and without evidence of disease at 12, 27, 30, 37 and 40 months.
One patient is alive with disease at 7 months and one died of progressive
disease at 6 months. The hematologic recovery after high-dose chemotherapy
was rapid and non-hematologic toxicities were usually mild and manageable.
Conclusions: High-dose chemothrapy followed by peripheral blood stem cell t
ransplantation is safe and effective for use in patients with far-advanced
testicular cancer, particularly when the high-dose chemotherapy is conducte
d as the initial treatment. Further larger and long-term follow-up studies
are needed to define the role of high-dose chemotherapy on testicular cance