Triple drug therapy in testicular tumors

Abstract

Thirty-four patients with disseminated choriocarcinoma, embryonal cell carcinoma, and teratocarcinoma of the testis were treated with triple drug therapy—chlorambucil, methotrexate, and actinomycin D as employed by Li et al. Although two-thirds of patients with measurable lesions had at least a 50% regression, reactivation usually occurred within 3 months. Four patients have complete regressions which are being maintained, the longest a seven and a half-year complete remission for a patient with choriocarcinoma. It is recognized that there is a high recurrence rate following orchiectomy even in patients with negative nodes. This fact coupled with the responsiveness of these radioresistant tumors to triple therapy, and without life-threatening toxicity, led us to employ this as adjuvant chemotherapy for one year in 13 patients following orchiectomy. There has been no recurrence in 11 of these patients, with the longest follow-up five and one-half years in a patient with choriocarcinoma. No patient in either series had x-ray therapy.