Motzer R J, Bosl G J
Urol Clin North Am. 1987 May;14(2):389-98.
With the advent of cisplatin-based chemotherapy and the incorporation of adjunctive surgery, 70 to 80 per cent of patients with advanced germ cell tumors are cured. Serum tumor markers are important diagnostically and prognostically and are necessary for monitoring response to therapy. Patients with germ cell tumors may be divided into "good risk" (high likelihood of complete response) and "poor risk" (low likelihood of complete response) based on pretreatment serum tumor markers, extent of disease, histology, and primary site. For "good-risk" patients, new treatments are being investigated that maintain efficacy and ameliorate toxicity. For "poor-risk" patients, innovative therapy is needed to increase the proportion of complete responders. Further progress will be made only through careful randomized trials and the discovery of new drugs.
随着基于顺铂的化疗的出现以及辅助手术的应用，70%至80%的晚期生殖细胞肿瘤患者得以治愈。血清肿瘤标志物在诊断和预后方面都很重要，并且对于监测治疗反应是必需的。根据治疗前血清肿瘤标志物、疾病范围、组织学和原发部位，生殖细胞肿瘤患者可分为“低风险”（完全缓解可能性高）和“高风险”（完全缓解可能性低）两类。对于“低风险”患者，正在研究能维持疗效并减轻毒性的新治疗方法。对于“高风险”患者，则需要创新疗法来提高完全缓解者的比例。只有通过严谨的随机试验和新药的发现才能取得进一步进展。
