Sitompul Ardiansyah Periadi, Prapiska Fauriski Febrian, Warli Syah Mirsya
Urology Division of Surgery Department, Adam Malik General Hospital, Sumatera Utara, Indonesia.
Open Access Maced J Med Sci. 2019 Apr 14;7(7):1148-1152. doi: 10.3889/oamjms.2019.201. eCollection 2019 Apr 15.
Penile tumour is a rare tumour in the genitourinary system, account for 0.4-0.6%. Although rare, patients are often unaware and come in late stage, so the use of chemotherapy agents is becoming crucial.
This study was conducted to evaluate responses and overall survival rate of Paclitaxel, Ifosfamide, and Cisplatin (TIP) regimen in penile cancer with nodal involvement.
We included all medical records of penile squamous cell carcinoma patients associated with nodal involvement who acquired TIP regimen in Adam Malik Hospital between 2014 and 2016. We administered 175 mg/m2 of Paclitaxel on day 1, 1200 mg/m2 of Ifosfamide on days 1 to 3, and 25 mg/m2 of Cisplatin on days 1 to 3 as our standard TIP regimen. The regimen was re-administered every 21-28 days. Characteristics of the patient including age, history of circumcision, races, primary lesion of the tumour and TNM staging were noted. Adverse event, clinical responses, and overall survival were assessed and evaluated.
We extracted data from 17 patients of penile cancer with nodal involvement who acquired TIP regimen with a mean age of 44.18 ± 11.13 years old from our medical records. Only 10 patients completed the full 4 cycles of the regimen. Four patients died before completion, two patients refused to continue the regimen, and 1 patient is still on the second cycle. Total penectomy was the most frequent procedure had taken, and clinical stage T4 and N3 was the most findings at initial diagnosis. There was no complete response noted. Six patients were noted as partial response, and 1 patient was noted as progressive disease. The Kaplan-Meier curve shows an overall 6 months (95% CI: 4.4-7.6 months) of survival with a median of follow-up time was 7 (1-11) months. In subgroup analysis, we found that the responder group has significantly better overall survival than the non-responder group (log-rank test, p = 0.004).
Paclitaxel, Ifosfamide, and Cisplatin (TIP) regimen give significant clinical benefit in penile cancer with nodal involvement.
阴茎肿瘤是泌尿生殖系统中的一种罕见肿瘤，占0.4 - 0.6%。尽管罕见，但患者往往未意识到，就诊时多处于晚期，因此化疗药物的使用变得至关重要。
本研究旨在评估紫杉醇、异环磷酰胺和顺铂（TIP）方案对有淋巴结转移的阴茎癌患者的疗效和总生存率。
我们纳入了2014年至2016年期间在亚当·马利克医院接受TIP方案治疗的所有伴有淋巴结转移的阴茎鳞状细胞癌患者的病历。我们采用的标准TIP方案为：第1天给予175mg/m²紫杉醇，第1至3天给予1200mg/m²异环磷酰胺，第1至3天给予25mg/m²顺铂。该方案每21 - 28天重复一次。记录患者的特征，包括年龄、包皮环切史、种族、肿瘤原发灶及TNM分期。评估不良事件、临床反应和总生存率。
我们从17例有淋巴结转移且接受TIP方案治疗的阴茎癌患者的病历中提取数据，这些患者的平均年龄为44.18±11.13岁。只有10例患者完成了全部4个周期的治疗。4例患者在完成治疗前死亡，2例患者拒绝继续治疗，1例患者仍在第二个周期。全阴茎切除术是最常采用的手术方式，初始诊断时临床分期T4和N3最为常见。未观察到完全缓解。6例患者为部分缓解，1例患者为疾病进展。Kaplan - Meier曲线显示总生存期为6个月（95%CI：4.4 - 7.6个月），中位随访时间为7（1 - 11）个月。在亚组分析中，我们发现缓解组的总生存率显著高于未缓解组（对数秩检验，p = 0.004）。
紫杉醇、异环磷酰胺和顺铂（TIP）方案对有淋巴结转移的阴茎癌具有显著的临床益处。
