This is in contrast to four of eight patients (50 percent) from the same institution obtaining long-term disease-free survival with local/regional radiotherapy and/or surgery. Loehrer and colleagues at Indiana University and the Southeastern Cancer Study Group report seven of nine patients (78 percent) with mediastinal seminoma obtaining complete remission with cispla-tin, bleomycin, and either etoposide or vinblastine. Seven of these patients had received prior radiotherapy to the chest alone. These results correspond to the excellent^suits obtained with cisplatin-based chemotherapy in patients with advanced testicular seminoma where durable complete remission rates of 80 to 90 percent are commonly obtained. ventolin 100 mcg
Current therapeutic rcommendations for mediastinal seminoma are in evolution. At Indiana University, patients with isolated mediastinal seminoma without evidence of metastatic disease are managed with mediastinal radiotherapy alone. Patients with extra-mediastinal spread are given cisplatin-based chemotherapy usually cisplatin, etoposide, and bleomycin. The alternative approach of managing all patients with pure primary mediastinal seminoma with cisplatin-based chemotherapy would be expected to yield comparable overall cure rates.
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