性腺外生殖细胞肿瘤患者的长期治疗结果。

Long term results of treatment in patients with extragonadal germ cell tumours.

作者信息

Gutierrez Delgado F, Tjulandin S A, Garin A M

机构信息

Department of Clinical Pharmacology and Chemotherapy, Cancer Research Center, Russian Academy of Medical Sciences, Moscow.

出版信息

Eur J Cancer. 1993;29A(7):1002-5. doi: 10.1016/s0959-8049(05)80211-4.

DOI:10.1016/s0959-8049(05)80211-4

PMID:7684595

Abstract

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.

摘要

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。