BEP(Bleomycin,Etoposide,Cisplatinum)療法による進行性性腺外胚細胞腫瘍の治療

Abstract

進行性性腺外胚細胞腫瘍5例で, 導入化学療法としてBVP(シスプラチン+ビンブラスチン+ブレオマイシン), 或いはBEP化学療法を行った.全例腫瘍マーカーは高値で多発遠隔転移があり, 栄養状態が不良であった.BVP療法2例は化学療法後6及び9ヵ月に死亡した.BEP療法3例は完全寛解を示し, 無病で1年以上生存した.顆粒球減少性発熱はBEP療法の1クール後間もなくにみられた.予防的顆粒球-コロニー形成刺激因子治療により, これら2例では発熱発作なしに総量化学療法を行い得た

Five patients with advanced extragonadal germ cell tumor (EGGCT) were treated with cisplatinum + vinblastine + bleomycin (BVP) or cisplatinum + etoposide + bleomycin (BEP) chemotherapy as an induction therapy. All patients had high levels of tumor markers and multiple distant metastasis in poor nutritious conditions. Two patients given BVP therapy died 6 and 9 months after the chemotherapy. By contrast, three patients given BEP therapy achieved complete remission and were surviving longer than one year without any evidences of disease. Granulocytopenic fever was seen soon after the first course of BEP therapy. Prophylactic granulocyte-colony stimulating factor (G-CSF) treatment, enabled two of them to receive full dose chemotherapy without any fever attacks. In conclusion, BEP chemotherapy is effective to EGGCT as well as far advanced testicular tumors and G-CSF treatment is useful for achievement of induction chemotherapy to advanced germ cell tumors.