Klinik für Innere Medizin IV, Onkologie/Hämatologie/Hämostaseologie am Universitätsklinikum Halle (Saale), Ernst-Grube-Strasse 40, Halle 06120, Germany.
Urology. 2011 Oct;78(4 Suppl):S456-68. doi: 10.1016/j.urology.2011.08.001.
The use of cisplatin-based combination chemotherapy has led to a dramatic improvement in the cure rate of patients with metastatic germ cell tumors (GCTs). With high complete response (CR) rates achieved in approximately 80% of patients with advanced testicular cancer after standard first-line cisplatin-based chemotherapy. Thereafter, the goals of various trials were to reduce the chemotherapy toxicity by limiting the number of chemotherapy cycles, the duration of therapy, and reducing the doses of, or even omitting, individual cytotoxic drugs, while maintaining efficacy, or to investigate the potential role of carboplatin as single agent or combined with etoposide and bleomycin for advanced seminoma. From prospective randomized trials and available data from additional sources, a European standard has been defined in several consensus conferences,(1-3) with the most recent consensus conference published by the European Society for Medical Oncology Consensus Group.(4,5) These international guidelines were developed from the previous published guidelines and data from available current trials. The principles of evidence-based medicine were scored (score 1-4) using a modified version of the Oxford levels of evidence and are listed in the present report in brackets. Draft guidelines were presented at an International Consensus in Urological Disease (ICUD) meeting (Shanghai, November 2009). The writing committee compiled the results of the discussion. All participants agreed to this final update.
基于顺铂的联合化疗的应用显著提高了转移性生殖细胞肿瘤（GCT）患者的治愈率。对于晚期睾丸癌患者，标准一线基于顺铂的化疗后约 80%的患者可获得高完全缓解（CR）率。此后，各种试验的目标是通过减少化疗周期数、治疗持续时间以及降低或甚至省略个别细胞毒性药物的剂量来降低化疗毒性，同时保持疗效，或研究卡铂作为单一药物或与依托泊苷和博来霉素联合用于晚期精原细胞瘤的潜在作用。在几个共识会议中，（1-3）已经确定了欧洲标准，最近一次共识会议由欧洲肿瘤内科学会共识小组发布。（4,5）这些国际指南是在以前发布的指南和现有试验的可用数据的基础上制定的。使用改良版牛津证据水平对循证医学原则进行评分（评分 1-4），并在本报告的括号中列出。指南草案在国际泌尿疾病共识会议（2009 年 11 月，上海）上提出。写作委员会汇编了讨论的结果。所有参与者均同意这一最终更新。
