Adjuvant chemotherapy for high-risk clinical stage I nonseminomatous testicular germ cell cancer: Long-term results of a prospective trial
Adjuvant chemotherapy for high-risk clinical stage I nonseminomatous testicular germ cell cancer: Long-term results of a prospective trial
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DOI：
10.1200/jco.1996.14.2.441
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发表时间：
1996-02-01
影响因子：
45.3
通讯作者：
Holtl, W
中科院分区：
文献类型：
--
作者：
Pont, J;Albrecht, W;Holtl, W
目的：评估短期辅助化疗对复发率、治疗相关发病率和长期毒性的影响，这些患者为具有高复发风险的临床I期非肿瘤性睾丸生殖细胞肿瘤（NSGCT I）患者，即原发肿瘤显示血管浸润（VI）的患者。从1985年1月至1995年1月，42例伴有VI的NSGCT I患者接受了两个疗程的顺铂、足叶乙甙和博莱霉素（FEB）治疗。其中，29例随访时间超过2年的患者是本报告的受试者。NSGCT我没有VI的患者被分配到一个监测程序，并作为控制长期toxicity.Results的评估：在一个中位随访时间为79个月（范围，27至119），两名患者复发。一个发展为完全分化的成熟畸胎瘤;另一个是真正的化疗失败，再次发展为胚胎癌。27例患者（93%）存活，无疾病证据; 1例患者（3%）死于进行性睾丸癌，另1例死于肺癌。两个疗程FEB均未引起严重急性不良反应。根据心血管和肺部疾病、生育能力和继发性肿瘤的临床和实验室证据以及社会心理问卷，对辅助化疗的晚期后遗症进行评估，与对照组相比，没有显示出任何显著的劣势。两个疗程的PEB辅助化疗是临床I期NSGCT患者的一种有效和合理的治疗选择，复发在超过6年的中位随访时间内，未发现不良晚期后遗症。(C)1996年，美国临床肿瘤学会。
Purpose: To assess the impact of short-term adjuvant chemotherapy on relapse rates, treatment-related morbidity, and long-term toxicity in patients with clinical stage I nonseminomatous testicular germ cell tumor (NSGCT I) who carry a high risk of relapse, ie, who show blood-vessel invasion (VI) by the primary tumor.Patients and Methods: From January 1985 to January 1995, 42 NSGCT I patients with VI were treated with two courses of cisplatin, etoposide, and bleomycin (FEB) after orchidectomy. Of these, 29 patients with a followup time of more than 2 years are the subject of this report. NSGCT I patients without VI were assigned to a surveillance program and served as controls for the assessment of long-term toxicity.Results: During a median follow-up time of 79 months (range, 27 to 119), two patients relapsed. One developed fully differentiated mature teratoma; the other was a true chemotherapy failure and again developed embryonal carcinoma. Twenty-seven patients (93%) are alive without evidence of disease; one patient (3%) died of progressive testicular cancer and another of lung cancer. The two courses of FEB did not cause any severe acute adverse reactions. The assessment of late sequels of adjuvant chemotherapy based on clinical and laboratory evidence of cardiovascular and pulmonary disease, fertility, and secondary neoplasms, as well as on a psychosocial questionnaire, did not show any significant disadvantages versus the control group.Conclusion: Adjuvant chemotherapy with two courses of PEB is an effective and reasonable treatment option for patients with clinical stage I NSGCT who carry a high risk of relapse. No adverse late sequelae were detected within a median follow-up time of more than 6 years. (C) 1996 by American Society of Clinical Oncology.