Athanassiou A, Pectasides D, Bafaloukos D, Barbounis V, Dimitriadis M, Christodoulou K
Department of Medical Oncology, Metaxas Memorial Cancer Hospital, Piraeus, Greece.
Br J Urol. 1989 May;63(5):525-30. doi: 10.1111/j.1464-410x.1989.tb05950.x.
Between 1979 and 1987 64 men with non-seminomatous germ cell tumours of the testis were treated with chemotherapy. Nearly half of these patients had large volume disease. The most frequently used combinations were VAB-6 and POMB/ACE. Chemotherapy lasted 3.9 months for small volume disease and 5.5 months for large volume disease. Seven patients (11%) underwent resection of residual masses; viable malignancy was found in only 1 of these. Relapse occurred in 6 complete responders, 3 of whom were salvaged with further chemotherapy. Fifty-three patients are presently alive and have received no treatment for periods of 5 to 86 months. Life table analysis forecasts a survival of 81%. Adverse prognostic factors have been recognised and include high initial serum concentrations of beta-human chorionic gonadotrophin (beta-HCG) and alpha fetoprotein (AFP), large volume disease and prior irradiation. Although the survival time of patients with advanced disease has improved in recent years, it remains considerably below that of patients who present with less advanced disease. Such patients should be treated aggressively from the outset in order to obtain maximum benefit from chemotherapy. Selected cases also require adjunctive surgery.
1979年至1987年间，64例睾丸非精原细胞瘤生殖细胞肿瘤患者接受了化疗。这些患者中近一半患有大量疾病。最常用的联合方案是VAB - 6和POMB/ACE。小体积疾病的化疗持续3.9个月，大体积疾病的化疗持续5.5个月。7例患者（11%）接受了残留肿块切除术；其中仅1例发现有存活的恶性肿瘤。6例完全缓解者出现复发，其中3例通过进一步化疗挽救。53例患者目前存活，且5至86个月未接受治疗。生命表分析预测生存率为81%。已确认的不良预后因素包括初始血清β-人绒毛膜促性腺激素（β-HCG）和甲胎蛋白（AFP）浓度高、大量疾病和既往放疗。尽管近年来晚期疾病患者的生存时间有所改善，但仍远低于疾病程度较轻患者的生存时间。此类患者应从一开始就积极治疗，以便从化疗中获得最大益处。部分病例还需要辅助手术。
