Oncological outcomes of metastatic testicular cancers under centralized management through regional medical network
Oncological outcomes of metastatic testicular cancers under centralized management through regional medical network
复制标题
通过区域医疗网络集中管理转移性睾丸癌的肿瘤结果
DOI：
10.1093/jjco/hyt152
复制
发表时间：
2013
期刊：
影响因子：
2.4
通讯作者：
Nishiyama H
中科院分区：
文献类型：
--
作者：
Inai H;Kawai K;Kojima T;Joraku A;Shimazui T;Yamauchi A;Miyagawa T;Endo T;Fukuhara Y;Miyazaki J;Uchida K;Nishiyama H
目的探讨诱导化疗的剂量强度和肿瘤学结果的转移性睾丸癌的集中管理下，通过区域医疗network.Materials和methodsWe回顾性分析了86例转移性睾丸癌患者谁给予诱导化疗在筑波大学医院和四个分支医院2000年1月至2010年11月的结果。原则上，预后不良疾病患者和具有博莱霉素、依托泊苷和顺铂风险因素的患者在化疗前被转诊至筑波大学医院。对于高危人群，依托泊苷和顺铂或依托泊苷，异环磷酰胺和顺铂被用作博来霉素，依托泊苷和cisplatin.ResultsOverall，56和30例患者在筑波大学医院和分支医院，分别治疗。根据国际生殖细胞癌症协作组的标准，47例、18例和21例患者分别被归类为预后良好、中等和预后不良的疾病。21例预后不良的患者中有18例（86%）从诱导化疗开始就在筑波大学医院接受治疗。在大多数患者中，高相对剂量强度的诱导化疗是可能的。各药物的平均相对剂量强度>0.96。诱导化疗以外的治疗程序有效集中; 74%的化疗后手术和所有二线或后续化疗在筑波大学医院进行。5年总生存率的好，中，差预后组分别为97，93和84%.ConclusionsInductive化疗与高相对剂量强度，化疗后手术和挽救化疗，通过集中管理有效地完成。肿瘤学结局非常好，尤其是预后不良的患者，其5年OS达到84%。
ObjectiveTo investigate the dose intensity of induction chemotherapy and oncological outcomes of metastatic testicular cancer under centralized management through a regional medical network.Materials and methodsWe retrospectively analyzed the outcomes of 86 metastatic testicular cancer patients who were given induction chemotherapy at Tsukuba University Hospital and four branch hospitals between January 2000 and November 2010. Principally, management of patients with poor-prognosis disease and patients having risk factors for bleomycin, etoposide and cisplatin were referred to Tsukuba University Hospital before chemotherapy. For high-risk groups, etoposide and cisplatin or etoposide, ifosfamide and cisplatin was used as an alternative to bleomycin, etoposide and cisplatin.ResultsOverall, 56 and 30 patients were treated at Tsukuba University Hospital and branch hospitals, respectively. Forty-seven, 18 and 21 patients were classified with good-, intermediate- and poor-prognosis disease, respectively, according to the International Germ Cell Cancer Collaborative Group criteria. Eighteen of the 21 patients (86%) with poor-prognosis disease were treated at Tsukuba University Hospital from the beginning of induction chemotherapy. Induction chemotherapy with a high relative dose intensity was possible in most patients. The average relative dose intensity of each drug was >0.96. Treatment procedures other than induction chemotherapy were efficiently centralized; 74% of post-chemotherapy surgery and all second-line or subsequent chemotherapies were performed at Tsukuba University Hospital. The 5-year overall survival rates of the good-, intermediate- and poor-prognosis groups were 97, 93 and 84%, respectively.ConclusionsInduction chemotherapy with high relative dose intensity, post-chemotherapy surgery and salvage chemotherapy was accomplished efficiently through centralization of management. Oncological outcomes were excellent, especially in patients with poor-prognosis disease, whose 5-year OS reached 84%.