Yilmaz F, Soyer N, Uslu R, Erdogan A P, Karaca B, Saydam G, Sahin F, Vural F
Department of Hematology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Department of Hematology, Ege University Hospital, Izmir, Turkey.
Indian J Cancer. 2017 Apr-Jun;54(2):415-420. doi: 10.4103/ijc.IJC_284_17.
About 20-25% of the testicular germ cell tumors (TGCT) are relapsed or refractory after first line therapy and optimal treatment for this group is poorly defined. We aimed to analyze the efficacy and safety of autologous stem cell transplantation (ASCT) in this patient group.Material and.
19 patients with 28 ASCT were retrospectively analyzed. All the patients were treated with BEP (Bleomycin, etoposide, cisplatin) as first line therapy and TIP(paclitexalifosfamide, cisplatin) was given as salvage chemotherapy. Stem cell collection was performed with TIP and granulocyte stimulating factor. ASCT was performed with carboplatin(700mg/m2) and etoposite(750mg /m 2). The results were provided as median(min-max). P<0.05 was accepted as statistical significant level.
After ASCT, complete(CR) and partial remission (PR) rates were 47.3% and 31 .5% respectively. The median overall survival(OS) and progression free survival (PFS) were 18(0-37.4 months) and 7(0-15months) months respectively. Estimated 2-year OS was 47.4% and PFS was 35.3%. Grade 3/4 toxicities including diarrhea, mucositis, and toxic hepatitis were observed in 5 patients. Only one patient died due to complication of transplantation.
Although the number of the patients in this study is limited, ASCT seems to be a safe and effective treatment modality in relapsed refractory non-seminomatousTGCT with an acceptable OS, PFS and mortality rates.
约20%-25%的睾丸生殖细胞肿瘤（TGCT）患者在一线治疗后会复发或难治，针对该群体的最佳治疗方法尚不明确。我们旨在分析自体干细胞移植（ASCT）在该患者群体中的疗效和安全性。材料与方法：对19例接受28次ASCT的患者进行回顾性分析。所有患者均接受BEP（博来霉素、依托泊苷、顺铂）作为一线治疗，TIP（紫杉醇、异环磷酰胺、顺铂）作为挽救性化疗。采用TIP和粒细胞刺激因子进行干细胞采集。ASCT采用卡铂（700mg/m²）和依托泊苷（750mg/m²）。结果以中位数（最小值-最大值）表示。P<0.05被视为具有统计学意义。结果：ASCT后，完全缓解（CR）率和部分缓解（PR）率分别为47.3%和31.5%。中位总生存期（OS）和无进展生存期（PFS）分别为18（0-37.4个月）和7（0-15个月）个月。估计2年OS为47.4%，PFS为35.3%。5例患者出现3/4级毒性反应，包括腹泻、黏膜炎和中毒性肝炎。仅1例患者因移植并发症死亡。结论：尽管本研究中的患者数量有限，但ASCT似乎是复发难治性非精原细胞瘤性TGCT的一种安全有效的治疗方式，其OS、PFS和死亡率均可接受。
