Department of Urology, Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, NS 6299, Canada.
Department of Medicine, Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, NS 6299, Canada.
Curr Oncol. 2022 Mar 8;29(3):1808-1812. doi: 10.3390/curroncol29030148.
A standard curative intent approach of chemotherapy treatment for metastatic testicular cancer has been well established. However, there is little guidance for patients undergoing hemodialysis (HD) who require chemotherapy for this disease. Thus, we describe our treatment approach and rationale for a patient on HD with poor risk metastatic nonseminomatous germ cell tumor involving the testicle, lymph nodes, liver, and bone. After orchiectomy, five cycles of cisplatin and modified dose etoposide were delivered and strategically timed with HD. Treatment was complicated by significant neuropathy. Surgical resection of two liver lesions was performed after chemotherapy. Ten years post-chemotherapy, he remains free of clinical, biochemical, or radiological recurrence. While our patient remains free of disease after this treatment, the optimal chemotherapy and dialysis dose and schedule to maximize cure and minimize toxicity remains unknown.
对于转移性睾丸癌，标准的治愈性化疗治疗方法已经得到充分确立。然而，对于需要化疗治疗这种疾病的血液透析（HD）患者，几乎没有指导。因此，我们描述了我们对一名 HD 患者的治疗方法和原理，该患者患有睾丸、淋巴结、肝脏和骨骼受累的高危转移性非精原细胞瘤。睾丸切除术后，给予了五周期顺铂和改良剂量依托泊苷，并与 HD 进行了策略性的时间安排。治疗过程中出现严重的神经病变。化疗后进行了两次肝病变的手术切除。化疗后 10 年，他仍然没有临床、生化或影像学复发的迹象。虽然我们的患者在这种治疗后仍然没有疾病，但仍不清楚最佳的化疗和透析剂量和方案，以最大限度地提高治愈率并最小化毒性。
