SEOM-GG 生殖细胞睾丸癌治疗临床指南(2023 年)。

IF 2.8 3区 医学 Q2 ONCOLOGY Clinical & Translational Oncology Pub Date : 2024-11-01 Epub Date: 2024-07-03 DOI:10.1007/s12094-024-03532-2
José Angel Arranz Arija, Xavier García Del Muro, Raquel Luque Caro, María José Méndez-Vidal, Begoña Pérez-Valderrama, Jorge Aparicio, Miguel Ángel Climent Durán, Cristina Caballero Díaz, Ignacio Durán, Enrique González-Billalabeitia
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引用次数: 0

摘要

睾丸生殖细胞瘤是青少年和年轻男性最常见的肿瘤。它们是可治愈的恶性肿瘤,治疗时应以治愈为目的,尽量减少急性和长期副作用。腹股沟睾丸切除术是主要的诊断方法,也是大多数局部肿瘤的根治方法,而有不利复发风险因素的患者,或无法或不愿接受密切随访的患者,可能需要辅助治疗。睾丸切除术后标记物持续存在或确诊时已是晚期的患者应根据 IGCCCG 预后分类进行分期和分类。BEP是最推荐的化疗方案,但也可使用其他方案,如EP或VIP,以避免某些患者使用博莱霉素。应尽可能避免不必要的延迟和剂量减少。每个周期后标记物下降不足与预后不良有关。精原细胞瘤和非精原细胞瘤患者化疗后残留肿块的处理方法有所不同。高复发风险患者、难治性肿瘤患者或化疗后复发的患者应由经验丰富的中心的多学科团队进行管理。对这些患者的挽救性治疗包括常规剂量化疗(TIP)和/或高剂量化疗,但针对每个亚组患者的最佳治疗方案和策略尚未完全确定。对于晚期复发患者,在可行的情况下应尽早进行完整的手术切除。鉴于 TGCT 的高治愈率,肿瘤学家应与患者一起预防和识别治疗可能产生的长期副作用。上述建议同样适用于对角线外腹膜后和纵隔肿瘤。
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SEOM-GG clinical guidelines for the management of germ-cell testicular cancer (2023).

Testicular germ cell tumors are the most common tumors in adolescent and young men. They are curable malignancies that should be treated with curative intent, minimizing acute and long-term side effects. Inguinal orchiectomy is the main diagnostic procedure, and is also curative for most localized tumors, while patients with unfavorable risk factors for recurrence, or those who are unable or unwilling to undergo close follow-up, may require adjuvant treatment. Patients with persistent markers after orchiectomy or advanced disease at diagnosis should be staged and classified according to the IGCCCG prognostic classification. BEP is the most recommended chemotherapy, but other schedules such as EP or VIP may be used to avoid bleomycin in some patients. Efforts should be made to avoid unnecessary delays and dose reductions wherever possible. Insufficient marker decline after each cycle is associated with poor prognosis. Management of residual masses after chemotherapy differs between patients with seminoma and non-seminoma tumors. Patients at high risk of relapse, those with refractory tumors, or those who relapse after chemotherapy should be managed by multidisciplinary teams in experienced centers. Salvage treatment for these patients includes conventional-dose chemotherapy (TIP) and/or high-dose chemotherapy, although the best regimen and strategy for each subgroup of patients is not yet well established. In late recurrences, early complete surgical resection should be performed when feasible. Given the high cure rate of TGCT, oncologists should work with patients to prevent and identify potential long-term side effects of the treatment. The above recommendations also apply to extragonadal retroperitoneal and mediastinal tumors.

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来源期刊
CiteScore
6.20
自引率
2.90%
发文量
240
审稿时长
1 months
期刊介绍: Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
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