進行性睾丸腫瘍に対するCis-diamminedichloroplatinumを中心とした併用化学療法

Abstract

1)進行性胚細胞性睾丸腫瘍7例(精上皮腫3例, 非精上皮腫4例)にCisdiamminedichloroplatinum (CDDP)単独療法(1例)とPVB (CDDP, ビンプラスチン, ブレオマイシンの組合せ)療法(6例)を施行し, 完全寛解3例, 部分寛解2例, 奏効率71.4%を得た.2) PBV療法で不変の肺転移例の残存腫瘤を摘除した.組織学的には良性奇形腫で, 化学療法と手術による奏効率は85.7%であった.3)副作用の主なものは消化器症状と骨髄抑制であった

The effect of single CDDP therapy and PVB therapy was examined in 7 cases of stage III germ cell testicular tumors with measurable metastases. The mean age of the patients was 30.6 years old, and their histological types of primary sites were seminoma in 3 cases, embryonal carcinoma in 2, immature teratoma in 1 case and embryonal carcinoma + teratoma in 1 case. In 1 case of seminoma, 375 mg of CDDP was administered. In 1 case of embryonal carcinoma + teratoma, 100 mg of CDDP and then 2 courses of PVB therapy were performed, and 3 courses of PVB therapy were given in all other cases. Three cases showed complete response, 2 cases partial response and 2 cases no change. Pulmonary metastatic nodules were extirpated after the PVB therapy in 1 of the cases showing no change, and the histological examination of these nodules was found to be mature teratoma. As a result, the effectiveness of the chemotherapy alone was 71.4%, and that of chemotherapy + surgical operation was 85.7%. Significance of intensive chemotherapy and necessity of extirpation of residual metastatic nodules after intensive chemotherapy in the management of advanced germ cell testicular tumors are stressed.