Gutierrez Delgado F, Tjulandin S A, Garin A M
Department of Clinical Pharmacology and Chemotherapy, Cancer Research Center, Russian Academy of Medical Sciences, Moscow.
Eur J Cancer. 1993;29A(7):1002-5. doi: 10.1016/s0959-8049(05)80211-4.
From 1979 to 1991 56 patients with extragonadal germ cell tumours (EGCT) received cisplatin based chemotherapy. From 16 patients with seminomatous EGCT 13 achieved complete remission (CR) with chemotherapy alone, 2 with additional radiotherapy with final CR rate of 94%. 5 (31%) patients developed relapses and at a median follow-up of 38 (5-103) months 11 (69%) are alive and 10 (62%) have no evidence of disease (NED). Only 7 patients with non-seminomatous EGCT reached CR with chemotherapy alone and 8 more with additional chemotherapy or surgery. Overall CR was 37% and 3 (20%) relapses have been observed. At a median follow-up of 26 (3-114) months 14 (35%) are alive and remain free of disease, 26 (65%) have died. By univariate analysis seminomatous EGCT patients had a significantly greater likelihood of achieving a CR, for non-seminomatous EGCT BEP induction chemotherapy was superior to VAB-6, and NSEGCT patients with serum levels > 2000 ng/ml had worse prognosis. Current staging systems are insufficient to predict the treatment outcome in EGCT.
1979年至1991年期间，56例性腺外生殖细胞肿瘤（EGCT）患者接受了以顺铂为基础的化疗。16例精原细胞瘤性EGCT患者中，13例仅通过化疗实现了完全缓解（CR），2例接受了额外放疗，最终CR率为94%。5例（31%）患者出现复发，在中位随访38（5 - 103）个月时，11例（69%）存活，10例（62%）无疾病证据（NED）。仅7例非精原细胞瘤性EGCT患者仅通过化疗达到CR，另有8例通过额外化疗或手术达到CR。总体CR率为37%，观察到3例（20%）复发。在中位随访26（3 - 114）个月时，14例（35%）存活且无疾病，26例（65%）死亡。单因素分析显示，精原细胞瘤性EGCT患者实现CR的可能性显著更高，对于非精原细胞瘤性EGCT，BEP诱导化疗优于VAB - 6，血清水平> 2000 ng/ml的非精原细胞瘤性EGCT患者预后较差。目前的分期系统不足以预测EGCT的治疗结果。
