Joshi Amit, Kalra Devanshi, Simha Vijai, Menon Nandini, Noronha Vanita, Bakshi Ganesh, Prakash Gagan, Pal Mahendra, Murthy Vedang, Menon Santosh, Sable Nilesh, Agrawal Archi, Rane Pallavi, Prabhash Kumar
Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 40012, India.
Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 40012, India.
Ecancermedicalscience. 2022 Jun 13;16:1408. doi: 10.3332/ecancer.2022.1408. eCollection 2022.
Malignant testicular neoplasms constitute about 1% of all cancers in males. This is one of the most common tumours in adolescents and young adult males. After the introduction of cisplatin-based chemotherapy, the survival of germ cell tumour patients, even those with poor prognostic risk factors, has significantly improved over the years. Second-line chemotherapy in patients who have progressed over the first-line cisplatin-based chemotherapy has shown convincing 5 years of overall survival (OS).
This study is a retrospective analysis of testicular cancer patients from 2014 to 2020 who have received salvage chemotherapy treatment at Tata Memorial Centre. Patient demographics, tumour characteristics and treatment details were recorded in a specific format, and progression-free survival and OS were analysed along with response to therapy.
A total of 46 testicular cancer patients from 2014 to 2020, who received second-line chemotherapy, were analysed from the database maintained at our hospital. The median age at diagnosis was 29.5 (18-60) years. Most of the patients (30, 65.2%) presented with lung metastasis and 11 (23.9%) patients with liver metastasis. Most of the patients (21, 45.6%) received vinblastine, ifosfamide and cisplatin, whereas 13 (28.2%) patients received paclitaxel, ifosfamide and cisplatin regimen and 7 (15.2%) patients received GemOx regimen as the second-line chemotherapy. Median OS was observed to be 33.97 months and median progression-free survival was 29.01 months.
Second-line chemotherapy in testicular germ cell tumours can result in long-term disease control and all patients who are fit to tolerate second-line therapy should be offered it. Patients with relapsed seminoma did better than relapsed non-seminomatous germ cell tumours.
恶性睾丸肿瘤约占男性所有癌症的1%。这是青少年和年轻成年男性中最常见的肿瘤之一。自从引入以顺铂为基础的化疗后，多年来生殖细胞肿瘤患者的生存率，即使是那些具有不良预后风险因素的患者，也有了显著提高。对于一线以顺铂为基础的化疗后病情进展的患者，二线化疗已显示出令人信服的5年总生存率（OS）。
本研究是对2014年至2020年在塔塔纪念中心接受挽救性化疗的睾丸癌患者进行的回顾性分析。患者的人口统计学特征、肿瘤特征和治疗细节以特定格式记录，并分析无进展生存期和总生存期以及对治疗的反应。
从我院维护的数据库中分析了2014年至2020年共46例接受二线化疗的睾丸癌患者。诊断时的中位年龄为29.5（18 - 60）岁。大多数患者（30例，65.2%）出现肺转移，11例（23.9%）患者出现肝转移。大多数患者（21例，45.6%）接受长春花碱、异环磷酰胺和顺铂治疗，而13例（28.2%）患者接受紫杉醇、异环磷酰胺和顺铂方案，7例（15.2%）患者接受吉西他滨联合奥沙利铂方案作为二线化疗。观察到中位总生存期为33.97个月，中位无进展生存期为29.01个月。
睾丸生殖细胞肿瘤的二线化疗可实现长期疾病控制，所有适合耐受二线治疗的患者都应接受该治疗。复发性精原细胞瘤患者的情况比复发性非精原生殖细胞肿瘤患者更好。
