De Palo G, Zambetti M, Pilotti S, Rottoli L, Spatti G, Fontanelli R, Musumeci R, Kenda R, Bombardieri E, Stefanon B
Division of Diagnostic Oncology, Instituto Nazionale Tumori, Milan, Italy.
Gynecol Oncol. 1992 Nov;47(2):239-46. doi: 10.1016/0090-8258(92)90113-w.
Twenty-four consecutive patients with nondysgerminomatous germ cell tumor of the ovary were treated after surgery with cisplatin, vinblastine, and bleomycin (PVB regimen). The cycle was repeated every 3 weeks for three to five courses. Fourteen patients had endodermal sinus tumor, and 10 had mixed germ cell tumors. Stage of disease (FIGO, 1986) was as follows: stage I, 6; stage IIc-IV, 17; and recurrence, 1 patient. All patients were monitored by alpha-fetoprotein and human chorionic gonadotropin. Only 1 patient had received previous chemotherapy. All 5 patients without residual disease and with negative marker levels in which PVB was used as adjuvant treatment were free of disease for a median duration of 59 months from the start of PVB. Of the 19 patients with measurable disease (evident disease or positive marker levels), complete remission was obtained in 16 (84%), but 5 of these relapsed. Therefore, treatment with PVB failed in 8 out of 19 patients (42%) with measurable disease. Toxicity was evident, but no patient died of it. Menses were regular in 11 patients whose initial surgery was conservative. PVB regimen is an effective but not a satisfactory treatment. The considerable failure rate of PVB treatment suggests the investigation of other regimens.
24例连续性卵巢非精原细胞瘤患者术后接受顺铂、长春碱和博来霉素治疗（PVB方案）。每3周重复1个周期，共进行3至5个疗程。14例患者为内胚窦瘤，10例为混合性生殖细胞肿瘤。疾病分期（国际妇产科联盟，1986年）如下：Ⅰ期6例；Ⅱc - Ⅳ期17例；复发1例。所有患者均通过甲胎蛋白和人绒毛膜促性腺激素进行监测。仅1例患者曾接受过化疗。所有5例无残留病灶且标志物水平阴性并使用PVB作为辅助治疗的患者，自PVB开始治疗起，无病生存期的中位数为59个月。在19例有可测量病灶的患者（明显病灶或标志物水平阳性）中，16例（84%）获得完全缓解，但其中5例复发。因此，在19例有可测量病灶的患者中，8例（42%）PVB治疗失败。毒性反应明显，但无患者因此死亡。11例初始手术为保守性手术的患者月经规律。PVB方案是一种有效的但并不令人满意的治疗方法。PVB治疗相当高的失败率提示需研究其他方案。
