Completion and toxicity of induction chemotherapy for metastatic testicular cancer: An updated evaluation of Japanese patients

Koji Kawai, Satoshi Ando, Shiro Hinotsu, Takehiro Oikawa, Noritoshi Sekido, Naoto Miyanaga, Toru Shimazui, Hideyuki Akaza

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14 Citations (Scopus)


Background: Combination of bleomycin, etoposide and cisplatin (BEP) remains the standard chemotherapy for testicular cancer. Since the development of BEP in the 1980s, there has been a considerable advance in supportive therapies, such as granulocyte colony-stimulating-factor and 5-HT3 antagonists. Therefore, we re-evaluated the completion and toxicity of BEP combined with modern supportive care. Methods: The medical records of all 42 testicular cancer patients who received induction chemotherapy at Tsukuba University Hospital were reviewed. Toxicities during the induction chemotherapy were graded according to the Japanese CTCAE v3.0. Results: Dose reduction was needed in only three patients. The subsequent chemotherapy was started at the planned 3 week interval or within 3 days of postponement in 89% of the treatment cycles. The average relative dose intensity (RDI) of bleomycin was 0.95, while that for etoposide and cisplatin was 0.97. There was no death due to toxicity. The most frequent toxicity was leukopenia (grade 3 in 44% and grade 4 in 55%). Post-chemotherapy diffusion capacity was significantly decreased in 30% of patients. Two patients developed bleomycin-induced pneumonitis, but recovered successfully. Sixteen patients received second line or salvage chemotherapy after BEP, subsequently. The overall 5 year cause-specific survival rate was 85%. Conclusion: BEP with high RDIs is acceptable if combined with modern supportive care, with acceptable toxicity profile in most patients.

Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalJapanese journal of clinical oncology
Issue number7
Publication statusPublished - Jul 2006


  • BEP
  • IGCCCG classification
  • Testicular cancer
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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