Attili Venkata Satya Suresh, Chandra Rama C, Anupama G, Loknath D, Bapsy P P, Dadhich Hemant K, Babu Govind K
Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore - 560 029, India.
J Cancer Res Ther. 2007 Jul-Sep;3(3):150-2. doi: 10.4103/0973-1482.37407.
In patients with small-volume disseminated disease of germ cell tumors, cure can be achieved with four cycles of bleomycin, etoposide, and cisplatin (BEP). However, around 20% of these cases are not curable. Strategies to improve cure rates have shown that none of the currently available modalities were superior to the others. Among the most used ones, BEP and VIP (etoposide, cisplatin, and ifosfamide) have been the most studied. However, there are no reports comparing the two, except for a few in abstract forms from southern India. Therefore, we did a treatment outcome and cost-effectiveness analysis of two chemotherapeutic regimens (BEP vs VIP) that are used in poor-prognosis metastatic germ cell tumors.
All male patients with germ cell tumors, diagnosed as having poor risk by IGCCCG, between January 2002 and December 2004 were included in the study. Clinical, laboratory, and other data were recorded. The patients were stratified into two categories on the basis of the type of chemotherapeutic regimen they received.
In all, 46 patients were analyzed, with a median follow up of 26.6 months. The baseline characteristics (age, stage, PS, histology, and serum markers) were not different in the two treatment arms. There is no significant difference in the outcome with either of the chemotherapeutic modalities. VIP is less cost effective and more toxic compared to BEP.
In view of the greater toxicity and cost of therapy, as well as lack of either overall or disease free survival advantage, VIP is not a preferred option for patients with high-risk germ cell tumors in the Indian setting and it is still advisable to treat patients with BEP.
对于患有小体积播散性生殖细胞肿瘤的患者，采用博来霉素、依托泊苷和顺铂（BEP）进行四个周期的治疗可实现治愈。然而，这些病例中约20%无法治愈。提高治愈率的策略表明，目前可用的治疗方式中没有一种优于其他方式。在最常用的治疗方式中，BEP和VIP（依托泊苷、顺铂和异环磷酰胺）是研究最多的。然而，除了印度南部少数以摘要形式发表的报告外，没有比较这两种治疗方式的报道。因此，我们对用于预后不良的转移性生殖细胞肿瘤的两种化疗方案（BEP与VIP）进行了治疗结果和成本效益分析。
纳入2002年1月至2004年12月期间所有经国际生殖细胞癌协作组（IGCCCG）诊断为高危的男性生殖细胞肿瘤患者。记录临床、实验室及其他数据。根据患者接受的化疗方案类型将其分为两类。
共分析了46例患者，中位随访时间为26.6个月。两个治疗组的基线特征（年龄、分期、体能状态、组织学和血清标志物）无差异。两种化疗方式的治疗结果无显著差异。与BEP相比，VIP的成本效益较低且毒性更大。
鉴于VIP治疗的毒性更大、成本更高，且在总生存期或无病生存期方面均无优势，在印度的情况下，VIP不是高危生殖细胞肿瘤患者的首选方案，对患者仍建议采用BEP治疗。
