ETOPOSIDE, CISPLATIN, BLEOMYCIN, AND CYCLOPHOSPHAMIDE (ECBC) AS 1ST-LINE CHEMOTHERAPY FOR POOR-RISK NONSEMINOMATOUS GERM-CELL TUMORS

Sixty-one patients with advanced metastatic non-seminomatous germ cell tumors were treated with etoposide 120 mg/m2, cisplatin 30 mg/m2, ble omycin 12 mg/m2, and cyclophosphamide 300 mg/m2 daily for four days; a nd additional bleomycin bolus injection of 15 mg was given on day 1. F ifty patients (82%) were treated with four to six courses at 3-week in tervals. Forty patients (66%) attained complete remission, and further 7 patients (11%) achieved a marker-negative partial remission account ing for a favorable response rate of 77%. Hematologic toxicity was con siderable and there were two treatment-related deaths. After a median observation time of 47 months (range 12 to 108 months), 43 patients we re alive, of which 38 had continuous complete remission, one a second complete remission, two marker-negative stable disease and two progres sive disease. Our results are similar to those reported by other inves tigators for poor-risk metastatic non-seminomatous germ cell tumors tr eated with dose-intensified regimens.