進行性胚細胞腫瘍に対するRisk Criteriaの検討

Abstract

進行性胚細胞腫瘍12例の治療経験, およびそのRisk criteriaについて検討を加えた.自験例でのretrospective studyではThe Indiana Staging Systemが最も有用である.より正確な予後の予測には第12染色体短腕の増幅等, 新たな予後因子の検索も必要である

The development of cisplatin-based chemotherapy has achieved a high cure rate in patients with advanced germ cell tumors (GCT) and it is more important to predict the prognosis of each patient before treatment and select the most suitable regimen of therapy. To date, 4 risk criteria for GCT are presented. From November, 1985 to April, 1991 our treatment protocol for GCT consisted of VAB-6 (vinblastine, actinomycin D, bleomycin, cisplatinum) or PVeBV (vinblastine, etoposide, bleomycin, high-dose cisplatin) as the induction chemotherapy and VIP (etoposide, ifosfamide, cisplatin) as the salvage chemotherapy. In total, 12 patients were entered on this protocol. They were divided into 2 groups based on the actual clinical course. Those who achieved complete remission within 3 cycles of chemotherapy were divided into "good response group" and others were into "poor response group". These results were compared with those classified by the 4 risk criteria. As a result of our study "The Indiana Staging System" seemed to be the most useful.