Alternating cycles of PVB and BEP in the treatment of patients with advanced seminoma

Jourik A. Gietema , Pax H.B. Willemse , Nanno H. Mulder , Jan Oldhoff , Elisabeth G.E. de Vries , Dirk Th. Sleijfer
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引用次数: 6

Abstract

33 patients (median age 39 years) with advanced seminoma were treated with 4 courses of alternating cisplatin-containing chemotherapy PVB/BEP (cisplatin, vinblastine and bleomycin; bleomycin, etoposide and cisplatin). Patients were classified as stage IIC (n = 7), IID (n = 9), III (n = 13) and IV (n = 4). 8 had had prior radiotherapy; 9 had an elevated beta human chorionic gonadotropin (βHCG). 30 patients were evaluable for response and 33 for toxicity. During chemotherapy 3 patients died, 1 due to malignant disease, another due to a cardiac arrest, and 1 patient of a bleomycin pneumonitis. 13 (43%) had a complete remission and 17 (57%) had a clinical partial remission (residual radiographic mass). At a median follow-up of 28 months (range 16–88), 3 patients relapsed, 6–8 months after entry. After completion of therapy there were 2 deaths, 1 due to bleomycin pneumonitis and 1 neither tumour nor treatment related. 26 of 33 (79%) patients achieved a continuously disease-free status. Leucocytopenia and thrombocytopenia of WHO grade 34 occurred in, respectively, 3233 (97%) and 2033 (61%) of the patients. This study shows that alternating PVB/BEP in this group yields comparable response rates with non-alternating schedules but at the expense of considerable toxicity.

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PVB与BEP交替周期治疗晚期精原细胞瘤的疗效观察
33例晚期精原细胞瘤患者(中位年龄39岁)接受4个疗程的含顺铂交替化疗PVB/BEP(顺铂、长春碱和博来霉素;博莱霉素、依托泊苷和顺铂)。患者分为IIC期(n = 7)、IID期(n = 9)、III期(n = 13)和IV期(n = 4)。9例人绒毛膜促性腺激素(βHCG)升高。30例患者可评价反应,33例可评价毒性。在化疗期间,3例患者死亡,1例因恶性疾病,1例因心脏骤停,1例因博来霉素肺炎。13例(43%)完全缓解,17例(57%)临床部分缓解(残余放射学肿块)。中位随访28个月(范围16-88),3例患者在入院后6-8个月复发。治疗结束后,有2例死亡,1例死于博莱霉素肺炎,1例与肿瘤和治疗无关。33例患者中有26例(79%)达到持续无病状态。WHO 34级白细胞减少症和血小板减少症患者分别为3233例(97%)和2033例(61%)。这项研究表明,在该组中交替使用PVB/BEP与非交替方案产生相当的反应率,但代价是相当大的毒性。
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