Kang Heeseok, Kim Tae-Joong, Kim Woo Young, Choi Chel Hun, Lee Jeong-Won, Kim Byoung-Gie, Bae Duk-Soo
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Gynecol Oncol. 2008 Oct;111(1):106-10. doi: 10.1016/j.ygyno.2008.05.033. Epub 2008 Jul 25.
The aim of this study was to investigate the outcome and reproductive function of patients with ovarian endodermal sinus tumor (EST) after cumulative high-dose combination chemotherapy with bleomycin, etoposide and cisplatin (BEP).
Between 1995 and 2006, 1034 patients with the diagnosis of ovarian cancer were treated at a single institution. Among these patients, 51 had a confirmed diagnosis of malignant ovarian germ cell tumor (MOGCT) including 20 cases of EST. We retrospectively reviewed those patients with EST, who received BEP as adjuvant chemotherapy. The doses were 15 mg/day of bleomycin on days 1 to 3, 100 mg/m(2)/day IV of etoposide on days 1 to 3 and 20 mg/m(2)/day of cisplatin on days 1 to 5. The median number of total cycles was six (range between three and nine).
The median age of the patients with EST was 18 years (range 5 to 36). All except two were nulliparous. The overall survival rate was 90% at a median follow-up of 70 months. Two patients (10%) had disease recurrence in the pelvis. Of the 15 patients who were treated with fertility-sparing surgery, all had regular menstruation following the completion of adjuvant chemotherapy, and two of these patients had pregnancies with live birth deliveries and no complications.
In patients with EST, the cumulative high-dose BEP regimen resulted in excellent overall survival and did not seem to impair ovarian function.
本研究旨在调查接受博来霉素、依托泊苷和顺铂（BEP）累积高剂量联合化疗的卵巢内胚窦瘤（EST）患者的治疗结果及生殖功能。
1995年至2006年间，一家机构共治疗了1034例诊断为卵巢癌的患者。其中，51例确诊为恶性卵巢生殖细胞肿瘤（MOGCT），包括20例EST。我们回顾性分析了那些接受BEP作为辅助化疗的EST患者。剂量为第1至3天博来霉素15mg/天，第1至3天依托泊苷100mg/m²/天静脉滴注，第1至5天顺铂20mg/m²/天。总周期数的中位数为6个（范围为3至9个）。
EST患者的中位年龄为18岁（范围为5至36岁）。除2例之外均未生育。中位随访70个月时，总生存率为90%。2例患者（10%）盆腔疾病复发。在接受保留生育功能手术治疗的15例患者中，辅助化疗结束后均月经规律，其中2例患者怀孕并顺产，无并发症。
对于EST患者，累积高剂量BEP方案可带来出色的总生存率，且似乎不会损害卵巢功能。
