Miyanaga N, Akaza H
Department of Urology, Tsukuba University, Japan.
Gan To Kagaku Ryoho. 1995 Oct;22(12):1771-6.
Through advances in chemotherapy with the appearance of the drug cisplatin, testicular cancer treatment has improved dramatically. Consequently, testicular cancer has become one of the group of tumors that can be completely cured. Even in advanced testicular cancer, a curative rate of approximately 70% is obtainable from first-line chemotherapy, commonly by BEP combination. The problem, however, is treatment of the remaining 30% of the patients who fail to respond to first-line chemotherapy or who relapse shortly after first-line chemotherapy. Supportive therapy strengthens the chemotherapy of testicular cancer, for example, high-dose chemotherapy with carboplatin and etoposide with autologus bone marrow rescue, either by autologus bone marrow transplantation or peripheral blood stem cell transplantation, which can cure 15% to 20% of patients whose disease has progressed during prior chemotherapy combined with cisplatin. Though more cases of relapse were observed with high-dose chemotherapy compared to first-line chemotherapy, and the long-term prognosis is unknown, we should evaluate the usefulness of high-dose chemotherapy as an initial treatment for testicular cancer patients with poor prognoses.
随着顺铂这种药物的出现，化疗取得了进展，睾丸癌的治疗有了显著改善。因此，睾丸癌已成为可以完全治愈的肿瘤群体之一。即使是晚期睾丸癌，一线化疗通常采用BEP联合方案，也可获得约70%的治愈率。然而，问题在于如何治疗其余30%对一线化疗无反应或在一线化疗后不久复发的患者。支持性治疗加强了睾丸癌的化疗，例如，采用卡铂和依托泊苷进行高剂量化疗并进行自体骨髓挽救，可通过自体骨髓移植或外周血干细胞移植来实现，这可以治愈15%至20%在先前顺铂联合化疗期间病情进展的患者。尽管与一线化疗相比，高剂量化疗观察到更多复发病例，且长期预后尚不清楚，但我们应该评估高剂量化疗作为预后不良的睾丸癌患者初始治疗方法的有效性。
