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治疗晚期丸癌的医学治疗方法

Darren R Feldman¹, George J Bosl, Joel Sheinfeld

¹Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.

|February 14, 2008

概括

先进的丸生殖细胞瘤治疗改善了生存率. 临床医生必须了解化疗方案和潜在的长期毒性,以有效管理丸癌症.

科学领域:

在瘤学瘤学.
医疗治疗医疗治疗

背景情况:

先进的丸生殖细胞瘤 (TGCT) 治疗在过去30年里有了显著的进化.
对于大多数晚期TGCT患者来说,长期生存现在是可以实现的.
临床医生需要对TGCT治疗方案及其毒性的最新知识.

研究的目的:

审查目前对高级TGCT的治疗方法.
详细说明与这些疗法相关的短期和长期并发症.

主要方法:

关于MEDLINE和Cochrane受控试验注册 (1966-2007) 的综合文献搜索.
包括英语研究,重点关注先进的TGCT,药物治疗,并发症和死亡率.
精选186篇文章,强调随机对照试验的治疗,并发症和晚期复发.

主要成果:

晚期TGCT的西斯普拉丁组合化疗是风险分层的 (良好的,中间的,不良的预后).
预后良好的患者通过以太化物-西斯普拉丁或西斯普拉丁-以太化物-白血素实现了~90%的持久缓解.
中等风险/低风险的标准治疗包括白素-乙托酸-西斯普拉丁;救援疗法提供治愈潜力.
慢性毒性包括心血管疾病,不孕症和二次恶性瘤;晚期复发是可能的.

结论:

基于证据的高级TGCT治疗指南是通过临床试验和风险分层建立的.
医疗专业人员必须意识到丸癌症治疗的潜在并发症.

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