Chang T K, Wong T T, Hwang B
Department of Pediatrics, Veterans General Hospital-Taipei, National Yang-Ming University, Taiwan.
Med Pediatr Oncol. 1995 Jun;24(6):368-72. doi: 10.1002/mpo.2950240606.
We have treated 13 children with primary intracranial germ cell tumors with the combination of vinblastine, bleomycin, cisplatin, and etoposide, the so-called VBPE regimen in the past seven years at one institution. The clinical diagnosis of these children were: three germinomas, seven non-germinomatous germ cell tumors, and three recurrent non-germinomatous germ cell tumors without previous chemotherapy. Of this group, three germinomas and three non-germinomatous germ cell tumors were treated primarily with VBPE plus radiotherapy. All of them responded completely, and were free of tumor. Primary VBPE regimen without radiotherapy was used in another four non-germinomatous germ cell tumors. After six courses of VBPE regimen, only one of the four patients achieved complete response for 30 months. VBPE regimen was used as salvage chemotherapy in three recurrent non-germinomatous germ cell tumors without previous chemotherapy. After six courses of VBPE regimen, two had complete response for 58+ months and 78+ months respectively. We concluded that in newly-diagnosed intracranial non-germinomatous germ cell tumors, the combination of chemotherapy VBPE regimen and radiotherapy led to good results. Primary chemotherapy with VBPE alone was not adequate for the treatment of non-germinomatous germ cell tumors. However, VBPE regimen might be one of the salvage therapies for recurrent germ cell tumors without chemotherapy before relapse.
在过去七年里，我们在一家机构用长春花碱、博来霉素、顺铂和依托泊苷联合方案（即所谓的VBPE方案）治疗了13例原发性颅内生殖细胞肿瘤患儿。这些患儿的临床诊断为：3例生殖细胞瘤、7例非生殖细胞性生殖细胞肿瘤以及3例既往未接受过化疗的复发性非生殖细胞性生殖细胞肿瘤。在这组病例中，3例生殖细胞瘤和3例非生殖细胞性生殖细胞肿瘤主要接受VBPE联合放疗治疗。所有这些患儿均完全缓解，且无肿瘤残留。另外4例非生殖细胞性生殖细胞肿瘤采用单纯VBPE方案进行初始治疗。经过六个疗程的VBPE方案治疗后，4例患者中只有1例获得了30个月的完全缓解。VBPE方案用于3例既往未接受过化疗的复发性非生殖细胞性生殖细胞肿瘤的挽救性化疗。经过六个疗程的VBPE方案治疗后，其中2例分别获得了58 +个月和78 +个月的完全缓解。我们得出结论，在新诊断的颅内非生殖细胞性生殖细胞肿瘤中，化疗VBPE方案与放疗联合可取得良好疗效。单纯用VBPE进行初始化疗不足以治疗非生殖细胞性生殖细胞肿瘤。然而，VBPE方案可能是复发前未接受过化疗的复发性生殖细胞肿瘤的挽救性治疗方法之一。
