Culine S, Lhommé C, Droz J P
Département de médecine, CRLC Val-d Aurelle, Montpellier, France.
Bull Cancer. 1997 Sep;84(9):919-21.
Malignant ovarian germ cell tumors are infrequent neoplasms that usually affect young and otherwise healthy females. The outcome of patients has been significantly improved by the introduction of cisplatin-based chemotherapy. After conservative surgery which both establishes the diagnostic and initiates therapy, the postoperative management should be adapted to histological type as well as to tumor stage. In patients with nonseminomatous germ cell tumors, the standard treatment is a combination of bleomycin, etoposide and cisplatin (BEP protocol). The number of cycles to be given is 3 when surgery is optimal, and 4 in patients with residual or metastatic disease. In patients with pure dysgerminomas, 4 cycles of BEP are the optimal treatment for advanced stages. In early stages, the alternative to chemotherapy (3 cycles of BEP) is radiotherapy, typically given to the ipsilateral hemipelvis and para-aortic nodes. Results are satisfactory with a long-term survival rate ranging from 80 to 100%, and a minimal toxicity yielding a reasonable probability of having normal offspring.
恶性卵巢生殖细胞肿瘤是一种罕见的肿瘤，通常影响年轻且其他方面健康的女性。基于顺铂的化疗方法的引入显著改善了患者的治疗结果。在进行了兼具诊断和启动治疗作用的保守手术后，术后管理应根据组织学类型和肿瘤分期进行调整。对于非精原细胞性生殖细胞肿瘤患者，标准治疗方案是博来霉素、依托泊苷和顺铂联合使用（BEP方案）。手术效果理想时给予3个疗程，有残留或转移性疾病的患者给予4个疗程。对于纯无性细胞瘤患者，4个疗程的BEP是晚期的最佳治疗方案。在早期，化疗（3个疗程的BEP）的替代方案是放疗，通常对同侧半骨盆和腹主动脉旁淋巴结进行放疗。结果令人满意，长期生存率在80%至100%之间，毒性最小，生育正常后代的可能性合理。
