Diarrhoea.
Diarrhoea.
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腹泻。
DOI：
10.1136/bmj.305.6844.52-b
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发表时间：
1992
影响因子：
--
通讯作者：
A. J. Hay
中科院分区：
文献类型：
--
作者：
A. J. Hay
编辑：在回顾生殖细胞肿瘤治疗的最新进展时，GM Mead表示，仅用化疗治疗颅内原发恶性畸胎瘤“有很大的治愈机会”。这一观点没有得到现有数据的支持，因为尽管用含有顺铂的化疗进行治疗，但颅内恶性畸胎瘤的预后很差。24在Mead提到的论文中只描述了一名恶性畸胎瘤患者，她在开始治疗三个月后死亡。据报道，接受头颅或颅髓放射治疗的这些肿瘤患者的五年生存率约为33%。似乎有必要在顺铂为主的化疗后进行综合治疗，以改善这类肿瘤的疗效。4一篇文献综述表明，当肿瘤完全由绒毛膜癌元素组成时，单靠化疗可能就足够了。4.虽然颅骨脊髓照射的短期和长期后遗症已经得到很好的认识，但现有的数据支持这样一种观点，即这些患者的主要关注点仍然是延长生存时间，而不是将治疗的后期影响降至最低。在这一亚组患者中，没有看到恶性生殖细胞肿瘤患者总体前景的改善。
EDITOR,-In reviewing the recent developments in the treatment of germ cell tumours GM Mead suggests that treating primary malignant intracranial teratoma with chemotherapy alone is associated" with a substantial chance of cure."'This view is not supported by the available data as intracranial malignant teratoma carries a poor prognosis despite treatment with cisplatin con-taining chemotherapy. 24 Only one patient with malignant teratoma was described in the paper that Mead refers to, and she died three months after the start of treatment. 5Five year survival rates of around 33% have been reported for patients with these tumours treated with either cranial or craniospinal irradiation." 7 Combined modality treatment, with craniospinal irradiation after cisplatin based chemotherapy, seems to be necessary to improve the results in this group of tumours. 4 A literature review suggests that chemotherapy alone may suffice when the tumour is made up exclusively of chorio-carcinomatous elements. 4 Although the short term and long term deleter-ious sequelae of craniospinal irradiation are well recognised,'the available data support the view that the main concern in these patients is still to prolong survival rather than minimise the late effects of treatment.'The improved overall outlook for patients with malignant germ cell tumours is not seen in this subgroup of patients.