Price P, Hogan S J, Bliss J M, Horwich A
Department of Clinical Oncology, Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
Eur J Cancer. 1990 Apr;26(4):453-7. doi: 10.1016/0277-5379(90)90015-l.
Tumour growth rates have been measured in metastatic non-seminomatous germ cell testicular tumours (NSGCTT) by estimating the rate of rise of tumour marker production (TMP). TMP was calculated for the time between orchidectomy and the start of chemotherapy in a group of 58 patients with metastatic NSGCTT treated with BEP combination chemotherapy (bleomycin, etoposide and cisplatin). Calculation of TMP (iu/l/day) took account of the continuing clearance of marker from the serum. TMP increased with time in 51 patients and this rise generally appeared to be exponential. The rate of this increase was expressed as the marker production doubling time (MPDT) and is a measure of the tumour growth rate. MPDT varied from 0.5 to greater than 80 days (45 cases) for AFP + ve patients and from 1.8 to greater than 80 days (34 cases) for HCG + ve patients. Patients who failed BEP first line therapy had shorter MPDTs than those who responded (AFP P = 0.08, HCG P = 0.003). It was found that patients with a MPDT less than or equal to 4 days were more likely to fail treatment than those who had a MPDT greater than 4 days (AFP P = 0.009, HCG P = 0.005). MPDTs were independent of initial serum marker concentration. Patients with small volume disease had longer MPDTs than patients with large volume disease (AFP P = 0.02, HCG P = 0.04). Rapid tumour growth rate reflected by short MPDT carries a poor prognosis in patients with NSGCTT treated by BEP chemotherapy.
通过估计肿瘤标志物产生率（TMP）来测量转移性非精原细胞性生殖细胞睾丸肿瘤（NSGCTT）的肿瘤生长速率。对一组58例接受BEP联合化疗（博来霉素、依托泊苷和顺铂）治疗的转移性NSGCTT患者，计算了睾丸切除术后至化疗开始之间的TMP。TMP（iu/l/天）的计算考虑了标志物从血清中的持续清除情况。51例患者的TMP随时间增加，且这种增加通常呈指数形式。这种增加的速率表示为标志物产生倍增时间（MPDT），是肿瘤生长速率的一种度量。AFP阳性患者的MPDT为0.5至大于80天（45例），HCG阳性患者的MPDT为1.8至大于80天（34例）。一线BEP治疗失败的患者MPDT比有反应的患者短（AFP P = 0.08，HCG P = 0.003）。发现MPDT小于或等于4天的患者比MPDT大于4天的患者更有可能治疗失败（AFP P = 0.009，HCG P = 0.005）。MPDT与初始血清标志物浓度无关。小体积疾病患者的MPDT比大体积疾病患者长（AFP P = 0.02，HCG P = 0.04）。在接受BEP化疗的NSGCTT患者中，由短MPDT反映的快速肿瘤生长速率预后较差。
