Division of Hematology-Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN 46202, USA.
Am J Clin Oncol. 2011 Jun;34(3):286-8. doi: 10.1097/COC.0b013e3181d6b518.
To evaluate rates of complete remission and overall survival for patients with relapsed pure seminoma treated with high-dose carboplatin and etoposide followed by peripheral blood stem cell transplant.
Forty-eight consecutive patients with relapsed pure seminoma who were treated with high-dose chemotherapy (HDCT) and autologous peripheral blood stem cell transplant between May 1996 and June 2006 were retrospectively reviewed. Upon relapse (first, second, or third relapse) patients were given HDCT with carboplatin 700 mg/m(2) and etoposide 750 mg/m(2) for 3 consecutive days followed by infusion of peripheral blood stem cells. Here, we review both response and survival.
Thirty-eight (79%) of 48 patients obtained a complete response (CR) with overall survival of 75%. Median follow-up of all patients was 45.6 months. Twenty-two (92%) of 24 patients in first relapse achieved CR and are still alive and continuously disease-free. Sixteen (67%) of 24 patients had HDCT as third- or fourth-line therapy with 67% CR and overall survival of 64%. There were 3 treatment-related deaths, all of which occurred as third- or fourth-line therapy.
HDCT results in high rates of both CR and overall survival in patients with first or later relapsed pure seminoma germ cell tumors.
评估接受大剂量卡铂和依托泊苷治疗后再发纯精原细胞瘤患者的完全缓解率和总生存率，这些患者随后接受了外周血干细胞移植。
回顾性分析了 1996 年 5 月至 2006 年 6 月期间接受大剂量化疗（HDCT）和自体外周血干细胞移植治疗的 48 例复发纯精原细胞瘤患者。在复发时（首次、第二次或第三次复发），患者接受 HDCT，卡铂 700mg/m²，依托泊苷 750mg/m²，连续 3 天，然后输注外周血干细胞。在这里，我们同时回顾了反应和生存情况。
48 例患者中有 38 例（79%）获得完全缓解（CR），总生存率为 75%。所有患者的中位随访时间为 45.6 个月。24 例首次复发患者中有 22 例（92%）获得 CR，且仍存活且无疾病持续存在。24 例患者中有 16 例（67%）接受了三线或四线 HDCT，CR 率为 67%，总生存率为 64%。有 3 例治疗相关死亡，均发生在三线或四线治疗中。
HDCT 可使首次或以后复发的纯精原细胞瘤生殖细胞瘤患者获得高的 CR 率和总生存率。
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