High‐dose chemotherapy for male germ cell tumor

High‐dose chemotherapy for male germ cell tumor
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男性生殖细胞肿瘤的大剂量化疗

DOI:
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发表时间:
2006
影响因子:
2.6
通讯作者:
M. Fujisawa
M. Fujisawa
中科院分区:
医学3区
文献类型:
--
作者:
I. Hara;H. Miyake;Yuji Yamada;A. Takenaka;M. Fujisawa

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摘要 目前,20-30%的男性晚期生殖细胞肿瘤患者尽管接受了以顺铂为基础的化疗,但仍未获得持久的完全缓解。大剂量化疗(HDCT)已尝试用于顺铂难治性GCT患者。最初,在重度治疗的患者中,进行HDCT并进行自体骨髓移植。然而,临床结果并不理想,与治疗相关的死亡率不容忽视。因此,早期引入HDCT联合外周血干细胞移植是可取的,因为它使HDCT更有效,毒性更小,而且多周期HDCT是可行的。对于难治性GCT患者,近期HDCT的持久无效率为32-65%。对于预后较差的GCT患者,HDCT也可作为一线化疗。尝试诱导化疗后进行多周期高密度CT扫描。近期HDCT作为一线化疗的持续无效率为43-73%。尽管先前的报道表明了HDCT的优越性,但最近的一项随机对照试验(RCT)并未显示与四个周期的标准剂量化疗(SDCT)相比,一个周期的HDCT加三个周期的标准剂量化疗(SDCT)有改善。对于预后较差的GCT患者,正在进行的RCT比较多个周期的HDCT和SDCT将阐明HDCT的作用。最近,含有紫杉醇的HDCT新方案已被设计出来。本文将对HDCT治疗晚期或难治性GCT的历史、现状和未来进行综述。
Abstract  Today, 20–30% of male patients with advanced germ cell tumor (GCT) do not have durable, complete remission in spite of cis‐platinum (CDDP)‐based chemotherapy. High‐dose chemotherapy (HDCT) has been tried in CDDP refractory GCT patients. Initially HDCT was performed with autologous bone marrow transplantation in heavily treated patients. However, the clinical outcome was not good and the treatment‐related death rate was not ignorable. Therefore, earlier introduction of HDCT with peripheral blood stem cell transplantation was preferable as it renders HDCT more effective and less toxic, and multicycle HDCT is feasible. The durable free rate of recent HDCT for refractory GCT patients is 32–65%. HDCT is also performed as first line chemotherapy for poor prognosis GCT patients. Induction chemotherapy followed by multicycles of HDCT was tried. The durable free rate of recent HDCT as first line chemotherapy is 43–73%. Although previous reports suggest the superiority of HDCT, one recent randomized controlled trial (RCT) failed to show an improvement with one cycle of HDCT followed by three cycles of standard‐dose chemotherapy (SDCT) compared with four cycles of SDCT. Ongoing RCT comparing multicycles of HDCT with SDCT for poor prognostic GCT patients will clarify the role of HDCT. Recently, new regimens of HDCT containing paclitaxel have been devised. In this review, the history, current status and future of HDCT for advanced or refractory GCT will be discussed.
DOI: 10.1038/sj.bmt.1703795
发表时间: 2003
期刊: Bone marrow transplantation.
影响因子: --
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Schulman,KA;Stadtmauer,EA;Reed,SD;Glick,HA;Goldstein,LJ;Pines,JM;Jackman,JA;Suzuki,S;Styler,MJ;Crilley,PA;Klumpp,TR;Mangan,KF;Glick,JH
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DOI: 10.1056/nejm198706043162302
发表时间: 1987-06-04
影响因子: 158.5
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通讯作者: LOEHRER, PJ
以外周血祖细胞支持为主要治疗的“剂量密集”高剂量化疗治疗晚期卵巢癌患者的 II 期研究。
DOI: 10.1200/jco.1998.16.5.1852
发表时间: 1998
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子: --
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通讯作者: Spriggs,DR
DOI: 10.1200/jco.1989.7.7.932
发表时间: 1989-07-01
影响因子: 45.3
作者:
NICHOLS, CR;TRICOT, G;JANSEN, J
通讯作者: JANSEN, J
对难治性生殖细胞肿瘤患者进行自体骨髓移植的高剂量卡铂、依托泊苷和环磷酰胺的药代动力学分析的 I 期试验。
DOI: --
发表时间: 1993
期刊: Cancer research
影响因子: 11.2
作者:
Motzer,RJ;Gulati,SC;Tong,WP;Menendez-Botet,C;Lyn,P;Mazumdar,M;Vlamis,V;Lin,S;Bosl,GJ
通讯作者: Bosl,GJ