Graham J, Harding M, Mill L, Kerr D J, Rankin E, Calman K C, Kaye S B
Cancer Research Campaign Department of Medical Oncology, Western Infirmary, Glasgow, UK.
Br J Cancer. 1988 Feb;57(2):182-5. doi: 10.1038/bjc.1988.38.
Between January 1981 and December 1985, 122 patients with non-seminomatous germ cell tumours (NSGT) were seen at a regional referral centre. Of these, a total of 98 patients received chemotherapy for metastatic disease. Treatment was given within collaborative EORTC Urology group studies, all of which involved cis-platin-containing schedules. Ninety patients had tumours of testicular origin, and their 2 year actuarial survival rate is 91%; 8 had tumours of extragonadal origin and their 2 year actuarial survival is 25%. Patients with testicular tumours were subdivided by volume of metastatic disease using the recommendations of the Testicular Cancer Subgroup of the MRC Urological Cancer Working Party and survival was significantly worse in the group with very large volume metastatic disease (VLVM, 57%) compared with the groups with large volume metastases (LVM, 100%) and small volume metastases (SVM, 98%). There were 31 patients with Stage I disease at presentation; of these 6 were treated by prophylactic abdominal radiotherapy and 25 were managed by a policy of surveillance only. Seven of these Stage I patients (23%) relapsed with metastatic disease (median 8 months); all have been successfully treated with chemotherapy. These data confirm that the majority of patients now presenting with metastatic NSGCT are curable with chemotherapy, but that a small proportion with very large volume metastases or extragonadal tumours require alternative chemotherapy schedules.
1981年1月至1985年12月期间，一家地区转诊中心共接待了122例非精原细胞瘤性生殖细胞肿瘤（NSGT）患者。其中，共有98例转移性疾病患者接受了化疗。治疗是在欧洲癌症研究与治疗组织（EORTC）泌尿外科协作组的研究中进行的，所有研究都采用了含顺铂的方案。90例患者的肿瘤起源于睾丸，其2年精算生存率为91%；8例患者的肿瘤起源于性腺外，其2年精算生存率为25%。睾丸肿瘤患者根据转移性疾病的体积，按照医学研究委员会（MRC）泌尿外科癌症工作组睾丸癌亚组的建议进行细分，与大体积转移（LVM，100%）和小体积转移（SVM，98%）组相比，非常大体积转移疾病（VLVM，57%）组的生存率明显更差。有31例患者初诊时为I期疾病；其中6例接受了预防性腹部放疗，25例仅采用观察策略进行管理。这些I期患者中有7例（23%）出现转移性疾病复发（中位时间8个月）；所有患者均已通过化疗成功治疗。这些数据证实，目前大多数出现转移性NSGCT的患者可通过化疗治愈，但一小部分有非常大体积转移或性腺外肿瘤的患者需要采用替代化疗方案。
