Pawinski A, Favalli G, Ploch E, Sahmoud T, van Oosterom A T, Pecorelli S
EORTC Data Centre, Brussels, Belgium.
Clin Oncol (R Coll Radiol). 1998;10(5):301-5. doi: 10.1016/s0936-6555(98)80081-2.
Dysgerminoma accounts for 1% of all ovarian cancers and for 50% of all ovarian germ cell malignancies. Low stage patients (50%) can be cured with local treatment. The aim of this trial was to study the objective tumour response rate and toxicity of PVB (cisplatin, vinblastine, bleomycin) chemotherapy in patients with pure advanced or recurrent dysgerminoma. Eighteen eligible patients with advanced dysgerminoma were entered into this study. Three patients had local bulky recurrence only; all the others also had metastatic disease. The median age at entry was 27 years (range 1348). Seventeen patients had had prior surgery and one had undergone prior radiotherapy. The WHO performance status was 0 in 12 patients, 1 in three patients, and 2 in three patients. The treatment consisted of: intravenous or intramuscular bleomycin 30 mg on days 2, 9 and 16, intravenous vinblastine 0.15 mg/kg on days 1 and 2, and intravenous cisplatin 20 mg/m2 on days 1-5. This regimen was given at 3-week intervals for a total of four cycles. Twelve patients obtained a complete response (66%), five a partial response (28%), and one could not be evaluated because radiotherapy was administered immediately after chemotherapy. After a median follow-up of 76 months (range 4-132), 14 (78%) patients were alive and well. Two died of disease progression, one of neutropenic septicaemia and one of lung fibrosis. No unusual toxicity was reported. Alopecia, as well as nausea and vomiting, were common. Leucopenia (78%), thrombocytopenia (17%) and infection (11%) were the other severe (grade 3-4) side effects. The PVB chemotherapy regimen is highly effective in patients with advanced ovarian dysgerminoma. However, the BEP (bleomycin, etoposide, cisplatin) regimen, which is equally as potent and less toxic, is preferred.
无性细胞瘤占所有卵巢癌的1%，占所有卵巢生殖细胞恶性肿瘤的50%。低分期患者（50%）可通过局部治疗治愈。本试验的目的是研究顺铂、长春花碱、博来霉素（PVB）化疗方案对纯晚期或复发性无性细胞瘤患者的客观肿瘤缓解率及毒性。18例符合条件的晚期无性细胞瘤患者进入本研究。3例仅局部有大块复发病灶；其他所有患者均有转移病灶。入组时的中位年龄为27岁（范围13 - 48岁）。17例患者曾接受过手术，1例曾接受过放疗。世界卫生组织（WHO）体能状态评分为0分的患者有12例，1分的有3例，2分的有3例。治疗方案包括：第2、9和16天静脉或肌肉注射博来霉素30mg，第1和2天静脉注射长春花碱0.15mg/kg，第1 - 5天静脉注射顺铂 20mg/m²。该方案每3周给药1次 ，共4个周期。12例患者获得完全缓解（66%），5例部分缓解（28%），1例因化疗后立即接受放疗无法评估。中位随访76个月（范围4 - 132个月）后，14例（78%）患者存活且状况良好。2例死于疾病进展，1例死于中性粒细胞减少性败血症 ，1例死于肺纤维化。未报告异常毒性。脱发以及恶心和呕吐很常见。白细胞减少（78%）、血小板减少（17%）和感染（11%）是其他严重（3 - 4级）副作用。PVB化疗方案对晚期卵巢无性细胞瘤患者非常有效。然而，博来霉素、依托泊苷、顺铂（BEP）方案同样有效且毒性较小，更受青睐。
