Salvage Therapy for Patients With Germ Cell Tumor.
Salvage Therapy for Patients With Germ Cell Tumor.
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DOI：
10.1200/jop.2016.011411
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发表时间：
2016-05-01
影响因子：
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通讯作者：
Einhorn, Lawrence H
中科院分区：
文献类型：
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作者：
Rashdan, Sawsan;Einhorn, Lawrence H
40年前，顺铂联合化疗的引入，将转移性睾丸生殖细胞肿瘤从一种几乎一致致命的疾病转变为一种可治愈的肿瘤模型。在铂类联合化疗时代之前，男性转移性睾丸生殖细胞瘤的5年生存率为5% ~ 10%。目前，转移性疾病患者的5年生存率为80%，总体生存率为95%。尽管生殖细胞肿瘤的治疗取得了实质性进展，但20%至30%的患者在一线化疗后会复发，需要额外的补救性治疗。标准剂量或大剂量化疗可治愈率≤50%。大剂量化疗后复发通常预后较差；然而，通过进一步的补救性化疗或补救性手术，仍有一小部分患者可能治愈。
The introduction of cisplatin combination chemotherapy, 40 years ago, transformed metastatic testicular germ cell tumors from an almost uniformly fatal disease into a model for a curable neoplasm. Before the era of platinum combination chemotherapy, the 5-year survival rate among men with metastatic testicular germ cell tumors was 5% to 10%. Currently, the 5-year survival rate is 80% for patients with metastatic disease and 95% overall. Despite the substantial advances in the treatment of germ cell tumors, 20% to 30% of patients will relapse after first-line chemotherapy and will require additional salvage therapies. Standard-dose or high-dose chemotherapy can cure ≤ 50% of these patients. Relapses after high-dose chemotherapy generally carry a poor prognosis; however, cure is still possible in a small percentage of patients by using further salvage chemotherapy or salvage surgery.