Nichols C R, Saxman S, Williams S D, Loehrer P J, Miller M E, Wright C, Einhorn L H
Department of Medicine, Indiana University School of Medicine, Indianapolis.
Cancer. 1990 Apr 1;65(7):1641-6. doi: 10.1002/1097-0142(19900401)65:7<1641::aid-cncr2820650731>3.0.co;2-u.
Between 1976 and 1988, 31 patients with mediastinal nonseminomatous germ cell tumors (MNGCT) received initial cisplatin-based chemotherapy of uniform intensity. Eighteen of these patients (58%) obtained disease-free status; 11 with chemotherapy alone and seven with adjunctive surgery. Eleven have remained continuously free of disease. Two have had recurrence of teratoma and are disease-free after resection of teratoma at 12+ and 68+ months. Three patients developed recurrence of germ cell tumor. Three patients developed a hematologic malignancy. Of the 18 patients who obtained disease-free status, 15 remain alive and disease-free. Overall, 13 of the 31 patients and 24 other patients received salvage chemotherapy at Indiana University, Indianapolis, Indiana. Of these 37 patients, six obtained a disease-free status and four (11%) remain alive at 13+, 56+, 78+, and 122+ months, respectively. This series represents the largest series of patients with MNGCT ever reported. Analysis of these data and results from other recent series suggest that approximately 50% of patients with MNGCT will be cured with modern, intense cisplatin-based chemotherapy coupled with adjunctive surgery if needed.
1976年至1988年间，31例纵隔非精原细胞性生殖细胞肿瘤（MNGCT）患者接受了初始强度一致的以顺铂为基础的化疗。其中18例患者（58%）获得无病状态；11例仅通过化疗，7例接受了辅助手术。11例持续无病。2例出现畸胎瘤复发，分别在12个月余和68个月余切除畸胎瘤后无病。3例患者出现生殖细胞肿瘤复发。3例患者发生血液系统恶性肿瘤。在获得无病状态的18例患者中，15例仍存活且无病。总体而言，31例患者中的13例以及其他24例患者在印第安纳州印第安纳波利斯的印第安纳大学接受了挽救性化疗。在这37例患者中，6例获得无病状态，4例（11%）分别在13个月余、56个月余、78个月余和122个月余时仍存活。该系列代表了迄今报道的最大规模的MNGCT患者系列。对这些数据的分析以及其他近期系列的结果表明，如果需要，大约50%的MNGCT患者将通过现代的、高强度的以顺铂为基础的化疗联合辅助手术治愈。
