Prompted by recent reports of the increasing incidence of late relapses in Stage 
1 patients with both malignant teratoma and seminoma on surveillance, a low 
toxicity regimen combining etoposide, bleomycin and cisplatin [EBCi(3)] with 
prolonged infusion of bleomycin, given daily for 3 days, has been developed for 
possible use as adjuvant treatment. Forty of 44 patients treated remain free of 
disease with a median follow-up of 21 months and actuarial disease free survival 
at 2 years of 91%. There have been no respiratory problems attributable to 
bleomycin lung toxicity in this study compared with four (3 associated with 
patient deaths) seen in 91 previously treated patients. The relatively low 
toxicity and high efficacy of this regime indicate that it may be suitable as 
adjuvant treatment.