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卵巢生殖细胞肿瘤的治疗结果:巴西国家癌症研究所十年经验

Outcomes of ovarian germ cell tumors: ten years of experience at the Brazilian National Cancer Institute.

作者信息

Lopes da Silva Jesse, Luiz Renna Nelson, Paulino Eduardo, de Melo Andréia Cristina

机构信息

Instituto Nacional do Câncer, Hospital do Câncer II, Rio de Janeiro, RJ, Brazil.

出版信息

Int J Gynecol Cancer. 2015 Jun;25(5):786-91. doi: 10.1097/IGC.0000000000000432.

Abstract

OBJECTIVE

Ovarian germ cell malignancies are a rare group of chemosensitive malignances that predominantly occur in young women. Bleomycin, etoposide, cisplatin (BEP) regimen was consolidated, by previous studies, as the standard treatment. This Brazilian single institutional study was performed to evaluate our experience in treating patients with ovarian germ cell tumors (OGCTs).

METHODS/MATERIALS: A retrospective analysis of all patients as having OGCTs, from April 2003 to July 2013, was carried out at the Brazilian National Cancer Institute.

RESULTS

Data on 30 patients were obtained, and 19 patients were treated with BEP. Median overall survival and progression-free survival were not reached. Just 4 (13.3%) patients had progressed and 5 (16.7%) had died up to the date of analysis. The proportion of patients who had dysgerminoma was 53.3%. From the 18 patients considered to have had an incomplete resection, 84.6% achieved objective response (partial or complete response) with chemotherapy. Patients with stage IV and incomplete resection had markedly ominous prognosis. Alopecia was the most frequent adverse event; grade 2 was presented in 17 (89.4%) patients. Nausea and vomiting were related by more than one-half of the patients. Grade 3 and 4 neutropenia was presented in 5 (26.3%) patients. One patient died of pneumonitis related to bleomycin.

CONCLUSIONS

Our study confirms the effectiveness of BEP regimen and the great prognosis for patients with OGCTs. Advanced-stage and persistent disease configured as an important risk factor for survival. The chemotherapy regimen was associated with significant but manageable toxicity.

摘要

目的

卵巢生殖细胞恶性肿瘤是一组罕见的对化疗敏感的恶性肿瘤,主要发生在年轻女性中。既往研究证实,博来霉素、依托泊苷、顺铂(BEP)方案是标准治疗方案。本巴西单中心研究旨在评估我们治疗卵巢生殖细胞肿瘤(OGCT)患者的经验。

方法/材料:对2003年4月至2013年7月在巴西国家癌症研究所诊断为OGCT的所有患者进行回顾性分析。

结果

共纳入30例患者,其中19例接受BEP方案治疗。总生存期中位数和无进展生存期中位数均未达到。截至分析时,仅4例(13.3%)患者病情进展,5例(16.7%)患者死亡。无性细胞瘤患者比例为53.3%。在18例被认为手术切除不完全的患者中,84.6%的患者通过化疗获得了客观缓解(部分或完全缓解)。IV期且手术切除不完全的患者预后明显不良。脱发是最常见的不良事件;17例(89.4%)患者出现2级脱发。超过一半的患者出现恶心和呕吐。5例(26.3%)患者出现3级和4级中性粒细胞减少。1例患者死于与博来霉素相关的肺炎。

结论

我们的研究证实了BEP方案的有效性以及OGCT患者的良好预后。晚期和持续性疾病是生存的重要危险因素。化疗方案毒性显著但可控。

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