TIP方案一线治疗晚期中高危睾丸生殖细胞肿瘤的回顾性分析

周莉; 迟志宏; 崔传亮; 盛锡楠; 斯璐; 唐碧霞; 毛丽丽; 王轩; 鄢谢桥; 连斌; 李思明; 白雪; 郭军

doi:10.3971/j.issn.1000-8578.2018.17.1417

TIP方案一线治疗晚期中高危睾丸生殖细胞肿瘤的回顾性分析

Efficacy and Safety of Paclitaxel, Ifosfamide and Cisplatin as First-line Treatment on Patients with Intermediate- or Poor-risk Advanced Testicular Cancer

摘要

摘要:
目的回顾性分析紫杉醇、异环磷酰胺联合顺铂（TIP）方案作为一线治疗晚期中高危睾丸生殖细胞肿瘤的疗效和安全性。
方法选取晚期中高危男性睾丸生殖细胞肿瘤患者，一线给予TIP方案进行治疗，评估该方案的客观有效率、2年的无进展生存率（PFS）和总生存率（OS）。
结果共20例患者纳入本研究，平均用药周期为4.25周期，6例患者获得完全缓解（30%），7例患者获得部分缓解（35%），客观有效率65%。中位随访时间25月，3例患者因肿瘤进展死亡。2年的PFS率为72.9%，OS率为89.1%。血液学毒性为最常见的不良反应（95%），其中3~4级中性粒细胞减少的发生率为30%。
结论 TIP方案一线治疗晚期中高危睾丸生殖细胞肿瘤较既往报道提高了患者的PFS率和OS率，不良反应可控，确立为一线方案仍需大样本临床研究。

Abstract:
Objective To assess the efficacy and safety of paclitaxel, ifosfamide and cisplatin (TIP) as the first-line treatment for the patients with intermediate- or poor-risk testicular cancer retrospectively.
Methods Patients with intermediate- or poor-risk testicular cancer in our center received TIP as the first-line treatment. Objective response rate, 2-year progression free survival(PFS) and overall survival(OS) were evaluated.
Results The mean treatment of 20 patients was 4.25cycles. Six patients achieved CR(30%), seven patients had partial response(35%) and overall response rate was 65%. The median follow-up time was 25 months. Three patients died of tumor progression. Hematologic toxicity was most common(95%), with 30% of grade 3-4 neutropenia. Estimated 2-year PFS was 72.9% and OS was 89.1%.
Conclusion Paclitaxel, ifosfamide and cisplatin(TIP) are safe and effective as the first-line treatment on patients with intermediate- or poor-risk testicular cancer. Compared with previous studies, 2-year PFS and OS have been improved. Adverse effect could be controlled. Further researches are still needed.

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