Currow D C, Findlay M, Cox K, Harnett P R
Department of Medical Oncology and Palliative Services, Nepean Hospital, Penrith, NSW, Australia.
Eur J Cancer. 1996 Dec;32A(13):2357-9. doi: 10.1016/s0959-8049(96)00346-2.
We carried out a retrospective review of the medical records of patients with metastatic carcinoma of unknown primary and either raised alpha fetoprotein (AFP) or beta human chorionic gonadotrophin (beta HCG) over a period of 6 years at three teaching hospital oncology units to assess response to platinum based chemotherapy. 15 patients were identified who fitted these criteria. Of these, 3 received no treatment because of poor functional status, 2 patients received only radiotherapy for symptomatic disease and died within 3 months of diagnosis and 1 patient died 2 weeks after diagnosis having received his first cycle of cisplatin-based chemotherapy. 9 patients received at least 2 cycles of chemotherapy. A complete tumour response was seen in only one patient who presented with midline lymphadenopathy and remains disease-free 46 months after treatment. This presentation was consistent with disease already known to herald platinum sensitivity. In the other 8 patients, there was only one partial response that lasted 2 months. The median survival for this group of 9 patients was 4.5 months (range 3 to > 46 months). Our data do not support the postulate that elevated germ cell markers in patients with carcinoma of unknown primary predict a response to cisplatin based chemotherapy.
我们对三家教学医院肿瘤科室6年间患有原发灶不明的转移性癌且甲胎蛋白（AFP）升高或β-人绒毛膜促性腺激素（β-HCG）升高的患者的病历进行了回顾性分析，以评估铂类化疗的疗效。确定了15例符合这些标准的患者。其中，3例因功能状态差未接受治疗，2例仅接受了针对症状性疾病的放疗，在诊断后3个月内死亡，1例在接受首个顺铂化疗周期后诊断2周死亡。9例患者接受了至少2个周期的化疗。仅1例表现为中线淋巴结病的患者出现了完全肿瘤缓解，治疗后46个月仍无疾病。这种表现与已知预示铂敏感性的疾病一致。在其他8例患者中，只有1例部分缓解持续了2个月。这9例患者的中位生存期为4.5个月（范围3至>46个月）。我们的数据不支持以下假设：原发灶不明的癌症患者中生殖细胞标志物升高预示对顺铂化疗有反应。
