Einhorn L H
Department of Medicine, Indiana University School of Medicine, Indianapolis.
Semin Oncol. 1994 Aug;21(4 Suppl 7):47-51.
Testicular cancer has become a model for a curable neoplasm. Approximately 70% of patients with disseminated disease will be cured with first-line chemotherapy regimens like cisplatin/etoposide/bleomycin. The concept of salvage therapy is simply to use active drugs not previously used in combination with cisplatin, the most active single agent. This strategy can be used with curative intent if the patient did not exhibit progressive disease during his initial cisplatin combination chemotherapy. Vinblastine/ifosfamide/cisplatin will cure approximately 25% of patients when used as second-line therapy. The cure rate for extragonadal presentation is extremely low, however. High-dose chemotherapy with carboplatin and etoposide with autologous bone marrow transplantation can cure 15% to 20% of patients whose disease progressed during prior cisplatin combination chemotherapy, or when the regimen is used as third-line or later chemotherapy. We are currently evaluating autologous bone marrow transplantation as initial salvage therapy.
睾丸癌已成为可治愈肿瘤的典范。约70%的播散性疾病患者可通过顺铂/依托泊苷/博来霉素等一线化疗方案治愈。挽救性治疗的理念就是使用先前未与最有效的单一药物顺铂联合使用过的活性药物。如果患者在初始顺铂联合化疗期间未出现疾病进展，那么这种策略可用于治愈目的。长春碱/异环磷酰胺/顺铂用作二线治疗时可治愈约25%的患者。然而，性腺外表现的治愈率极低。使用卡铂和依托泊苷进行高剂量化疗并联合自体骨髓移植可治愈15%至20%在先前顺铂联合化疗期间疾病进展的患者，或者当该方案用作三线或更晚的化疗时。我们目前正在评估自体骨髓移植作为初始挽救性治疗的效果。
