Germ cell tumors in children: gonadal and extragonadal.
Germ cell tumors in children: gonadal and extragonadal.
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儿童生殖细胞肿瘤：性腺和性腺外。
DOI：
10.1002/mpo.2950190405
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
J. Woodruff
中科院分区：
文献类型：
--
作者：
N. Wollner;F. Ghavimi;A. Wachtel;Enrique Luks;P. Exelby;J. Woodruff
63例儿童生殖细胞肿瘤患者的症状，组织学检查结果，分期，血清学标志物，治疗和治疗反应的细节。原发部位：卵巢32例，睾丸17例，骶前7例，纵隔3例，腹腔内2例，阴道1例，右侧腹股沟管1例。这些患者接受T2（放线菌素D、多柔比星、长春新碱和环磷酰胺序贯使用，伴或不伴放疗）、T6（环磷酰胺、博莱霉素、放线菌素D、多柔比星、甲氨蝶呤、长春新碱联合化疗）或VAB治疗方案（维本、放线菌素D、博莱霉素、顺铂）治疗。I期卵巢和睾丸生殖细胞肿瘤的治愈率为100%; III期所有原发部位的治愈率为82%，IV期所有原发部位的治愈率为75%。未成熟恶性畸胎瘤类型的卵巢肿瘤的组织学预后;神经型未成熟畸胎瘤，II级和III级，预后最差。初次减瘤手术联合化疗和放疗在生殖细胞肿瘤中起着重要作用。II、III和IV期生殖细胞肿瘤需要积极的手术、放疗和化疗治疗。对于患有原发性卵巢恶性肿瘤的I期患者，仅手术治疗可在50%的病例中实现治愈，并且在睾丸肿瘤中约70%的患者中实现治愈。对于I期和血清学标志物升高的患者，可以遵循这些标志物，在有持续升高或初始下降后滴度升高的证据之前不进行治疗。在那些血清学标志物没有升高的患者中，在采取“等待和观望”方法之前，应该考虑肿瘤的大小和组织学类型。这些I期肿瘤在首次出现时是高度可治愈的，但如果允许复发，化疗可能无法为患者提供如此有利的反应和治愈率。
Sixty-three pediatric patients with germ cell tumors are presented with details of symptoms, histological findings, staging, serological markers, treatment, and response to therapy. The primary sites were: ovarian 32, testicular 17, presacral 7, mediastinal 3, intraabdominal 2, vaginal 1, and right inguinal canal 1. These patients were treated with T2 (sequential use of dactinomycin, doxorubicin, vincristine, and cyclophosphamide, with or without radiation), T6 (combination chemotherapy with cyclophosphamide, bleomycin, dactinomycin, doxorubicin, methotrexate, vincristine), or VAB treatment protocols (velban, dactinomycin, bleomycin, cisplatin). The cure rate for stage I ovarian and testicular germ cell tumors was 100%; for stage III, all primary sites, 82% and for stage IV, all primary sites, 75%. Histology was prognostic in ovarian tumors of the immature malignant teratoma type; the neural type immature teratoma, grades II and III, had the worst prognosis. Initial debulking surgery in combination with chemotherapy and radiation plays an important role in germ cell tumors. Stages II, III, and IV germ cell tumors require aggressive treatment with surgery, radiation, and chemotherapy. For stage I patients, with primary ovarian malignant tumor, cure with surgery alone can be achieved in 50% of the cases and in testicular tumors in about 70% of the patients. For those with stage I and elevated serological markers, it is feasible to follow these markers and give no treatment until there is evidence of persistent elevation or a rise in titers after an initial fall. In those without elevated serological markers, one should take into consideration the size of the tumor and the histological type before taking the "wait and see" approach. These stage I tumors are highly curable when they first present but, if allowed to recur, chemotherapy may not offer the patient such a favorable response and cure rate.
依托泊苷加顺铂和 VAB-6 交替周期治疗低危生殖细胞肿瘤患者。
DOI：
10.1200/jco.1987.5.3.436
发表时间：
1987
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Bosl,GJ;Geller,NL;Vogelzang,NJ;Carey,R;Auman,J;Whitmore,WF;Herr,H;Morse,M;Sogani,P;Chan,E
通讯作者：
Chan,E