Cisplatin-based chemotherapy is highly effective in advanced seminoma, but
at the cost of a considerable toxicity. The response rate of carboplatin is
comparable with cisplatin combinations but the relapse rate is higher. Our
study assesses the efficacy and the toxicity of the combination of carbopl
atin and cyclophosphamide in patients with advanced seminoma.
Nineteen consecutive patients received 6 cycles of intravenous cyclophospha
mide 750 mg/m(2) and carboplatin 350 mg/m(2), repeated every 21 days. The o
verall objective response rate was 100%, 11 patients (58%) achieved a compl
ete response and 8 patients (42%) showed a partial response. At median foll
ow up of 4.2 years 3 patients (15%) relapsed. The 2-year disease-free survi
val and the overall survival are 72 and 94%, respectively. This outpatient
treatment was well tolerated and the toxicity was mild. One patient had gra
nulocytopenic fever and one patient had grade 3 cystitis. The combination t
herapy with carboplatin and cyclophosphamide is an effective and tolerable
regimen in advanced seminoma.