晚期睾丸癌治疗效果分析

Analysis of Advanced Nonseminomatous Germ Cell Tumors

摘要: 目的　评价晚期睾丸癌的治疗方法及预后因素。方法　 34例经病理证实的Ⅳ期睾丸癌患者接受以化疗为主的综合治疗, 化疗主要采用PVB或PEB方案。结果　总的 5年生存率为 5 3%, 化疗有效率为 91%。PVB与PEB方案 5年生存率分别为 5 0 %及 5 5 %, 无明显统计学差别, 但PVB毒副作用高于PEB。疗前血肿瘤标记物正常与升高者 5年生存率分别为 10 0 %及 4 3% ;单纯肺转移及广泛肺外转移者 5年生存率分别为 72 %及 31%, 均有明显统计学差别。结论　以化疗为主的综合治疗明显提高了疗效 ;PEB可作为治疗晚期睾丸癌患者的一线方案 ;疗前血LDH, HCG, AFP水平的高低, 组织学类型, 肺外转移灶的存在是影响预后的主要因素。

Abstract: Objective To evaluate the treatment results and prognostic factors of advanced nonseminomatous germ cell tumors. Methods From January 1990 to December 1997,34 patients with stage Ⅳ nonseminomatous germ cell tumors were treated mainly by chemotherapy and PEB or PUB. Chemotherapy was the main treatment and PEB or PVB was the main regimen. Results The overall 5-year survival rate was 53%. The response rate was 91%. There were no significant difference between PEB group and PVB group.The toxicity in PVB grou...