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タイトル: | 転移期精巣腫瘍における腫瘍崩壊症候群(Tumor lysis syndrome ; TLS)のリスク評価とTLS 発症頻度 |
その他のタイトル: | Incidence and Risk Assessment of Tumor Lysis Syndrome in Patients with Advanced Germ Cell Cancer |
著者: | 黒部, 匡広 河合, 弘二 田中, 建 市岡, 大士 吉野, 喬之 神鳥, 周也 河原, 貴史 和久, 夏衣 高岡, 栄一郎 小島, 崇宏 常楽, 晃 末富, 崇弘 宮崎, 淳 西山, 博之 |
著者名の別形: | Kurobe, Masahiro Kawai, Koji Tanaka, Ken Ichioka, Daishi Yoshino, Takayuki Kandori, Shuya Kawahara, Takashi Waku, Natsui Takaoka, Ei-ichirou Kojima, Takahiro Joraku, Akira Suetomi, Takahiro Miyazaki, Jun Nishiyama, Hiroyuki |
キーワード: | Tumor lysis syndrome Germ cell tumor |
発行日: | 31-May-2016 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 62 |
号: | 5 |
開始ページ: | 237 |
終了ページ: | 242 |
抄録: | Tumor lysis syndrome (TLS) is a major oncological emergency. TLS is common in patients with hematological malignancies, but it can occur across a spectrum of cancer types. Germ cell tumors (GCT) have rapid cancer cell turnover and often present with bulky metastasis. The international TLS expert consensus panel has recommended guidelines for a medical decision tree to assign low, intermediate and high risk to patients with cancer at risk for TLS. GCT is classified as intermediate risk for TLS, and the patients who have other TLS risks factors are classified to be at high risk for TLS. In this study, we retrospectively analyzed 67 patients with metastatic GCT who were treated with induction chemotherapy at Tsukuba University Hospital between 2000 and 2013. Thirty-one, 15 and 21 patients were classified with good-, intermediate- and poor-prognosis disease, respectively, according to the International Germ Cell Cancer Collaborative Group criteria. Twelve patients (18%) were classified to be at high risk for TLS, and two patients were treated with allopurinol or rasburicase as prophylaxes for TLS. They did not show progression to laboratory TLS (L-TLS). In the remaining 10 TLS high-risk patients, three (30%) patients developed L-TLS after chemotherapy and started receiving oral allopurinol. As a result, no patients developed clinical TLS (C-TLS). In this study, 30% of TLS-high risk patients developed L-TLS without prophylactic treatment. Therefore, it is important to conduct TLS-risk stratification and consider prophylaxis such as rasburicase for advanced GCT patients at induction chemotherapy. |
著作権等: | 許諾条件により本文は2017/06/01に公開 |
URI: | http://hdl.handle.net/2433/215104 |
PubMed ID: | 27320114 |
出現コレクション: | Vol.62 No.5 |
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