低剂量诱导化疗联合 Baby-BOP 方案治疗转移性生殖细胞肿瘤不影响预后：单中心经验。

Low-dose induction chemotherapy with Baby-BOP in patients with metastatic germ-cell tumours does not compromise outcome: a single-centre experience.

机构信息

Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK; Department of Oncology-Haematology, Kantonsspital St Gallen, Switzerland.

Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK.

出版信息

Ann Oncol. 2010 Aug;21(8):1589-1593. doi: 10.1093/annonc/mdq019. Epub 2010 Feb 17.

DOI:10.1093/annonc/mdq019

PMID:20164149

Abstract

BACKGROUND

In some institutions advanced metastatic germ-cell tumour (GCT) is treated with low-dose induction chemotherapy in specific settings. There is a lack of published data supporting its use. The data presented here specifically address this issue for the first time.

PATIENTS AND METHODS

Twenty patients with metastatic GCT treated were with low-dose induction chemotherapy [Baby-BOP (bBOP)] between 1998 and 2009. We report the toxicity and outcome and compare it with a control group.

RESULTS

bBOP was well tolerated with no treatment-related deaths and a lack of chemotherapy-related toxicity. It was associated with a significant fall in tumour markers (median HCG fell from 35 195 to 11 028 IU/l). The first subsequent cycle of standard chemotherapy was administered a median of 9.5 days after initial treatment and was not associated with excess toxicity. The 2-year overall survival of the poor-prognosis patients treated with bBOP was 79.0% [95% confidence interval (CI) 48% to 93%], which is not significantly different from the 2-year overall survival of 80% [95% CI 55% to 92%] of the poor-prognosis patients, who did not receive bBOP.

CONCLUSION

Low-dose induction chemotherapy can be given safely in selected individuals and does not adversely affect subsequent chemotherapy or outcome.

摘要

背景

在某些机构中，对于特定情况下的晚期转移性生殖细胞瘤（GCT），采用低剂量诱导化疗进行治疗。目前缺乏支持其使用的已发表数据。本文首次专门针对这一问题提供了相关数据。

患者与方法

1998 年至 2009 年间，我们对 20 例转移性 GCT 患者采用低剂量诱导化疗（Baby-BOP，bBOP）进行治疗。我们报告了毒性和结果，并与对照组进行了比较。

结果

bBOP 耐受性良好，无治疗相关死亡，且无化疗相关毒性。它与肿瘤标志物的显著下降相关（中位数 HCG 从 35195IU/l 降至 11028IU/l）。初始治疗后，中位数为 9.5 天开始接受标准化疗的后续周期，且无额外毒性。接受 bBOP 治疗的预后不良患者的 2 年总生存率为 79.0%（95%置信区间 48%至 93%），与未接受 bBOP 治疗的预后不良患者的 2 年总生存率 80%（95%置信区间 55%至 92%）相比，无显著差异。