精巣腫瘍の新しいSalvage化学療法(Cisplatin,Adriamycin,Bleomycin,Methotrexate,Etoposide)の試み

Abstract

PVB療法, VAB-6療法に不応または再発した進行性精巣腫瘍3例にCDDP, ADM, BLM, MTX, etoposideの5剤併用によるsecond line化学療法(CABME療法)を4クール行い, CR 1例, PR 1例の結果をえた。CABME療法は, 高度の骨髄抑制を認めた以外には重篤な副作用はなく, 薬剤耐性になりにくく肝転移には効果を認めた

Three patients with advanced non-seminomatous testicular tumor were treated with a new salvage chemotherapy. All patients were refractory to prior PVB (cisplatinum, vinblastine, bleomycin) or VAB-6 (cisplatinum, bleomycin, vinblastine, dactinomycin, cyclophosphamide) therapy. They were treated with the following combination chemotherapy: Cisplatin 30 mg/body day 1-5; adriamycin 40 mg/body day 1; bleomycin 30 mg/body/day 1: methotrexate 400 mg/body day 1; etoposide 150 mg/body day 1-5 (CABME therapy). This treatment was repeated monthly and in total four courses were given. One complete response and one partial response were obtained. Especially, we achieved 65% and 63% remission of liver metastases and residual tumors could be resected. Myelosuppression was marked, but other toxicity was tolerable. Therefore, we postulated that CABME therapy played an important role for the refractory testicular tumors.