Saxman S B, Nichols C R, Einhorn L H
Indiana University School of Medicine, Division of Hematology/Oncology, Indianapolis 46202.
J Clin Oncol. 1994 Jul;12(7):1390-3. doi: 10.1200/JCO.1994.12.7.1390.
Patients with relapsed extragonadal germ cell tumors (EGCT) are usually treated in an identical fashion as patients with recurrent testicular cancer. However, little is known about the long-term outcome in these patients and whether they have comparable results to patients with a testicular primary tumor. The purpose of this study was to evaluate the effect of salvage chemotherapy on long-term survival in patients with EGCT.
We conducted a retrospective review of 73 patients with relapsed extragonadal nonseminomatous germ cell tumors (GCTs) treated at Indiana University between 1976 and 1993. All patients received cisplatin-containing regimens as primary chemotherapy.
Only five of 73 patients (7%) were long-term disease-free survivors after salvage chemotherapy. The remaining 68 patients are either dead of disease or toxicity (n = 63), or alive with progressive disease (PD) (n = 5). Twenty-eight patients received high-dose chemotherapy with autologous bone marrow transplant (ABMT) at some point during their disease, and none of these patients are continuously disease-free.
Although similar salvage chemotherapy strategies will cure approximately 30% of patients with recurrent testicular cancer, new approaches are needed for EGCT.
复发性性腺外生殖细胞肿瘤（EGCT）患者的治疗方式通常与复发性睾丸癌患者相同。然而，对于这些患者的长期预后以及他们是否能取得与睾丸原发性肿瘤患者相当的结果，人们了解甚少。本研究的目的是评估挽救性化疗对EGCT患者长期生存的影响。
我们对1976年至1993年间在印第安纳大学接受治疗的73例复发性性腺外非精原细胞性生殖细胞肿瘤（GCT）患者进行了回顾性研究。所有患者均接受含顺铂方案作为初始化疗。
73例患者中只有5例（7%）在挽救性化疗后成为长期无病生存者。其余68例患者要么死于疾病或毒性反应（n = 63），要么带进展性疾病（PD）存活（n = 5）。28例患者在病程中的某个阶段接受了高剂量化疗及自体骨髓移植（ABMT），但这些患者中无一例持续无病生存。
尽管类似的挽救性化疗策略可治愈约30%的复发性睾丸癌患者，但EGCT需要新的治疗方法。
