Gutierrez-Delgado F, Titov D A, Tjulandin S A, Garin A M
Fred Hutchinson Cancer Research Center, Seattle, Washington 19024, USA.
Neoplasma. 1999;46(3):190-5.
This study retrospectively evaluated the influence of drug dose delivery components (DDDC) of bleomycin, etoposide and cisplatin chemotherapy for metastatic nonseminomatous germ cell tumors on treatment outcome (NSGCT). Between December 1987 and January 1995, 75 NSGCT patients were treated with a median of 4 cycles (range 3-8) of cisplatin 120 mg/m2 on day 1, etoposide 100 mg/m2 on days 1 through 5 and bleomycin 30 U on days 1, 3, and 5 every 3 weeks. DDDC, such as cumulative dose, cumulative dose in mg/m2, dose intensity (DI), relative dose intensity (RDI), dose intensity products, and relative dose intensity products by drug, were calculated and tested as possible predictors of treatment outcome in patients classified according to Indiana University (IU), and International Germ Cell Cancer Cooperative Group (IGCCCG) classifications. Overall complete response (CR) rate was 64%, and 3-year progression-free survival (PFS) was 59%. By IU classification there were statistical differences in CR and survival between moderate (89-81%) and advanced disease (42-40%) (p < 0.005), while for patients classified according to IGCCCG criteria, statistical differences in CR and PFS there were not registered. DI (mg/m2/week) and RDI values for the entire group were: cisplatin 33-0.82; etoposide 133-0.80 and bleomycin 11-0.37. We did not observe a statistically significant difference in drug dose delivery components for treatment outcome between patients who achieved a CR and incomplete response when analyzed by either extent of disease or whole group. Extent of disease was the most important predictor of treatment outcome.
本研究回顾性评估了博来霉素、依托泊苷和顺铂化疗的药物剂量递送成分（DDDC）对转移性非精原细胞性生殖细胞肿瘤（NSGCT）治疗结果的影响。1987年12月至1995年1月期间，75例NSGCT患者接受了中位4个周期（范围3 - 8个周期）的化疗，具体方案为：第1天顺铂120 mg/m²，第1至5天依托泊苷100 mg/m²，每3周的第1、3和5天给予博来霉素30 U。计算并测试了DDDC，如累积剂量、mg/m²累积剂量、剂量强度（DI）、相对剂量强度（RDI）、剂量强度乘积以及每种药物的相对剂量强度乘积，将其作为根据印第安纳大学（IU）和国际生殖细胞癌协作组（IGCCCG）分类的患者治疗结果的可能预测指标。总体完全缓解（CR）率为64%，3年无进展生存期（PFS）为59%。根据IU分类，中度疾病（89 - 81%）和晚期疾病（42 - 40%）之间的CR和生存率存在统计学差异（p < 0.005），而根据IGCCCG标准分类的患者，未发现CR和PFS存在统计学差异。整个组的DI（mg/m²/周）和RDI值分别为：顺铂33 - 0.82；依托泊苷133 - 0.80和博来霉素11 - 0.37。当按疾病范围或整个组进行分析时，我们未观察到达到CR和未完全缓解的患者之间在药物剂量递送成分对治疗结果方面存在统计学显著差异。疾病范围是治疗结果的最重要预测指标。
