Or

Regimen 2 (HDP/EB)

Cisplatin 1.3 mg/kg/IV on days 1-5

Etoposide 3 mg/kg/IV on days 1-5

Bleomycin 0.5 units/kg on day 1

SS.S mg/m2/IV on days l, 2, and S 167 mg/m2/IV over days l, 2, and S Is units/m2/IV on day 1

40 mg/m2/IV on days 1-5 1GG mg/m2/IV on days 1-5 15 units/m2 on day 1

Note: Disease is evaluated in week 12. If complete remission then discontinue chemotherapy; If partial remission then surgery (week 12) followed by two more cycles of chemotherapy as above (weeks 13 and 16).

Table 24-7. Chemotherapy Regimens for Malignant Germ Cell Tumors

Site

Histology

Therapy

Testicular

Stage I

Radical inguinal orchiectomy only

Testicular

Stage II

PEB or HDP/EB every 3 weeks, x3 cycles

Testicular

Stages III and IV

PEB or HDP/EB every 3 weeks, x3 cycles followed by surgery

If no disease (CR), discontinue therapy; if PR, 3 more cycles and repeat surgery

Ovarian

Stages I and II

PEB or HDP/EB every 3 weeks x3 cycles

Ovarian

Stages III and IV

PEB or HDP/EB every 3 weeks, x3 cycles followed by surgery

If CR, discontinue therapy; if PR, 3 more cycles and repeat surgery

Malignant

Stages I-IV

PEB or HDP/EB every 3 weeks, x3 cycles followed

Extragonadal

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