Therapeutic outcome of G-CSF therapy for the treatment of advanced testicular tumors

In the present study, we assessed the effect of granulocyte colony-stimulating factor (G-CSF) on patients with advanced testicular tumors. The subjects were 24 patients with stage II B or higher, advanced testicular tumors treated in the Department of Urology, Okayama University Hospital during the 12-year period from 1980 to 1991 (5, stage II B and 19, stage III: 19 primary cases and 5 recurrent cases). We compared the intensity of the CDDP dose against prognosis in 24 patients, 12 of whom were treated prior to 1986 when G-CSF had not been available, the other 12 patients being treated after 1987 using G-CSF. The CDDP dose intensity was increased significantly from 16.9-32.2 mg/m²/wk (20.6 ± 6.2 mg/m²/wk, mean ± SD) to 20.9-37.0 mg/m²/wk (29.6 ± 5.2 mg/m²/wk) after the introduction of G-CSF (t-test, p < 0.001). The 5-year survival rate was 40% in those patients treated without G-CSF as opposed to 90% after the introduction of G-CSF, and this result was statistically significant (logrank test, p = 0.04). Before the introduction of G-CSF, adverse reactions such as leukocytopenia forced us to reduce the doses and to change the schedules. Chemotherapy could be performed at full doses and on schedule due to the concomitant use of G-CSF, with the result that the therapeutic outcome was much improved.