Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG)
Tóm tắt
Following the establishment of adjuvant carboplatin in stage I testicular seminoma as a standard, we adopted this treatment for all stage I seminoma patients. We report our 8-year experience and compare these results with our previous adjuvant etoposide/cisplatin (EP) strategy. Patients with stage I seminoma, treated with adjuvant carboplatin and with a minimum follow-up of 1 year, were included. Two cycles of carboplatin [area under the curve (AUC) 6] were administered. A total of 138 patients with median age of 34 years, treated from September 2003 to December 2011, were selected. There were 5 relapses [5-year relapse-free rate (RFR) 96.8 % (95 % confidence interval 91.6–98.8)]: 3 relapses at retroperitoneal lymph nodes, 1 relapse at the adrenal gland, and 1 isolated brain metastasis. Four patients with relapse were cured with salvage chemotherapy. All patients with relapse had tumor diameter ≥4 cm and/or age ≤34 years. Patients with at least 1 of the above risk factors (n = 111) had a significantly higher relapse rate compared with a similar population (n = 64) treated with 2 cycles of adjuvant EP: 5-year RFR was 95 % (SE 2 %) versus 100 % (SE 0 %), (p = 0.067). Age and tumor diameter were associated with relapse in stage I seminoma treated with adjuvant carboplatin. Although adjuvant carboplatin in patients with age ≤34 and/or tumor diameter ≥4 cm is associated with higher relapse rates than EP, the prognosis of these patients is excellent, and therefore, the use of less toxic treatment is justified.
Tài liệu tham khảo
Fossa SD, Horwich A, Russell JM et al (1999) Optimal planning target volume for stage I testicular seminoma: a Medical Research Council randomised trial. J Clin Oncol 17:1146–1154
Schmoll HJ, Souchon R, Krege S et al (2004) European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG). Ann Oncol 15:1377–1399
Schmoll HJ, Jordan K, Huddart R, ESMO Guidelines Working Group et al (2010) Testicular seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v140–v146. doi:10.1093/annonc/mdq176
Carver BS, Motzer RJ, Kondagunta GV et al (2005) Late relapse of testicular germ cell tumors. Urol Oncol 23:441–445
NCCN (2011) Clinical practice guidelines in oncology: testicular cancer. Version 2.2011. www.nccn.org/professionals/physician_gls/pdf/testicular.pdf. Accessed 10 Oct 2012
Nuver J, Smit AJ, van der Meer J et al (2005) Acute chemotherapy-induced cardiovascular changes in patients with testicular cancer. J Clin Oncol 23(36):9130–9137
Travis LB, Fosså SD, Schonfeld SJ et al (2005) Second cancers among 40,576 testicular cancer patients: focus on long-term survivors. J Natl Cancer Inst 97(18):1354–1365
Haugnes HS, Bosl GJ, Boer H et al (2012) Long-term and late effects of germ cell testicular cancer treatment and implications for follow-up. J Clin Oncol 30(30):3752–3763
Jones WG, Fosså SD, Mead GM et al (2005) Randomized trial of 30 versus 20 Gy in the adjuvant treatment of stage I testicular seminoma: a report on Medical Research Council Trial TE18, European Organisation for the Research and Treatment of Cancer Trial 30942 (ISRCTN18525328). J Clin Oncol 23:1200–1208
Oliver RT, Mason MD, Mead GM et al (2005) Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet 366:293–300
Aparicio J, Garcia del Muro X, Maroto P et al (2003) Multicenter study evaluating a dual policy of postorchiectomy surveillance and selective adjuvant single-agent carboplatin for patients with clinical stage I seminoma. Ann Oncol 14:867–872
Brenner DJ, Hall EJ (2007) Computed tomography: an increasing source of radiation exposure. N Engl J Med 357:2277–2284
van Walraven C, Fergusson D, Earle C et al (2011) Association of diagnostic radiation exposure and second abdominal-pelvic malignancies after testicular cancer. J Clin Oncol 29:2883–2888
Warde P, Specht L, Horwich A et al (2002) Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol 20:4448–4452
Aparicio J, Germà JR, García del Muro X et al (2005) Risk-adapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study. J Clin Oncol 23:8717–8723
Bamias A, Aravantinos G, Deliveliotis C et al (2007) Two cycles of etoposide/cisplatin cured all patients with stage I testicular seminoma: risk-adapted protocol of the Hellenic Cooperative Oncology Group. Urology 70:1179–1183
Horwich A, Mason M, Dearnaley DP (1992) Use of carboplatin in germ cell tumors of the testis. Semin Oncol 19(Suppl 2):72–77
Dieckmann KP, Krain J, Küster J, Brüggeboes B (1996) Adjuvant carboplatin treatment for seminoma clinical stage I. J Cancer Res Clin Oncol 122(1):63–66
Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16(1):31–41
Oliver RT, Mead GM, Rustin GJ et al (2011) Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol 29:957–962
Fossa SD, Horwich A, Russell JM et al (1999) Optimal planning target volume for stage I testicular seminoma: a Medical Research Council randomized trial. J Clin Oncol 17:1146–1154
Cohn-Cedermark G, Stahl O, Tandstad T, SWENOTECA (2015) Surveillance vs. adjuvant therapy of clinical stage I testicular tumors—a review and the SWENOTECA Experience. Andrology 3:102–110
Kollmannsberger C, Tandstad T, Philippe L, Bedard P, Cohn-Cedermark G et al (2015) Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance. J Clin Oncol 22:51–57
Dieckmann KP, Brüggeboes B et al (2000) Adjuvant treatment of clinical stage I seminoma: Is a single course of carboplatin sufficient? Urology 55(1):102–106
Aparicio J, Maroto P, García del Muro X et al (2011) Risk-adapted treatment in clinical stage I testicular seminoma: the third Spanish Germ Cell Cancer Group study. J Clin Oncol 29:4677–4681
Steiner H, Scheiber K, Berger AP et al (2011) Retrospective multicentre study of carboplatin monotherapy for clinical stage I seminoma. BJU Int 107(7):1074–1079
Oldenburg J, Fosså SD, Nuver J (2013) Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Supplement 6):vi125–vi132
Albers P, Albrecht W, Algaba F et al (2011) EAU guidelines on testicular cancer: 2011 update. Eur Urol 60:304–319
National Comprehensive Cancer Network NCCN (2012) Clinical Practice Guidelines in Oncology for Testicular Cancer, NCCN. http://www.nccn.org (Version 1.2015)
Aparicio J, Maroto P et al (2014) Prognostic factors for relapse in stage I seminoma: a new nomogram derived from three consecutive, risk-adapted studies from the Spanish Germ Cell Cancer Group (SGCCG). Ann Oncol 2014(25):2173–2178
Chung P, Daugaard G, Tyldesley S et al (2015) Evaluation of a prognostic model for risk of relapse in stage I seminoma surveillance. Cancer Med 4(1):155–160
Warde P, Gospodarowicz M, Banerjee D et al (1997) Prognostic factors for relapse in stage I testicular seminoma treated with surveillance. J Urol 157:1705–1709
Pliarchopoulou K, Pectasides D (2010) Late complications of chemotherapy in testicular cancer. Cancer Treat Rev 36(3):262–267. doi:10.1016/j.ctrv.2009.12.011
Powles T, Robinson D, Shamash J et al (2008) The long-term risks of adjuvant carboplatin treatment for stage I seminoma of the testis. Ann Oncol 19:443–444