精巣腫瘍に対するBEP (Bleomycin,Etoposide,Cisplatin)療法の経験

Abstract

11例の精巣腫瘍(非セミノーム8例, セミノーム3例)に対してBEP療法を施行した.3例には再発予防の目的, 8例には転移巣に対する治療の目的でこの化学療法を施行した.11例中10例は再発がなく生存中であるが, choriocarcinomaが遠隔転移の主体と思われる非セミノーム精巣腫瘍の1例のみがpartial responseにとどまった.BEP療法後を後腹膜リンパ節郭清術を施行した3例では, 腫瘍細胞の残存は認めず線維化のみであった.副作用としては白血球減少が最も重要で, 他の副作用は許容範囲内であり, PVB (cisplatin, vinblastine, bleomycin)療法のvinblastineをetoposideに変えたBEP療法では認められなかった

We describe our experience with BEP (bleomycin, etoposide, cisplatin) therapy as chemotherapy for testicular tumors in 11 patients. Eight were non-seminomatous testicular cancer patients and 3 were seminoma patients. Three of 8 non-seminomatous testicular cancer patients had no evident metastasis and BEP therapy was performed for prophylaxis of recurrence. Other 5 non-seminomatous testicular cancer patients and 3 seminoma patients had metastatic lesions and BEP therapy was performed to cure these metastatic lesions. Ten of our 11 patients are living and disease-free. One non-seminomatous testicular cancer patient who had brain, lung, eye and bladder metastases and had an extremely elevated human chorionic gonadotropin (hCG) level responded only partially and died later due to disease progression. Side effects in most patients were nausea, vomiting, alopecia and leucopenia and all these side effects were reversible. Neuromuscular toxicity such as paresthesia or abdominal cramp that is sometimes encountered in PVB (cisplatin, vinblastine, bleomycin) therapy was not seen in our patients. Our results support the concept that BEP therapy is better than PVB therapy as an initial chemotherapy for testicular tumors.