市立堺病院での睾丸腫瘍の治療経験(睾丸腫瘍59例の臨床統計)

Abstract

59例の睾丸腫瘍中進行癌5例にCDDPを含む多剤併用療法を試みたところ, 導入療法の成否が予後を大きく左右する結果を得た.この点でVAB-6療法は, 積極的に試みるprotocolと思われた

Fifty-nine cases of testicular cancers were admitted to our hospital between 1960 and 1984. Thirty cases were seminoma (patients aged 12-64 years) and 29 cases were non-seminoma (6 patients were 1-7 years old and 23 were 17-44 years old). One of each of the seminoma and non-seminoma cases was not included in our analysis due to death before sufficient treatment. Of the remaining 29 cases of seminoma, 24 were in stage I, 4 in stage II, and 1 was in stage III. Of the remaining 22 adult cases of non-seminoma, 15 were in stage I, 2 in stage II, and 5 in stage III. Most of the cases with seminoma were treated with radiation after orchiectomy. Two of the cases of advanced seminoma and all of the cases of non-seminoma without mature teratoma were treated with retroperitoneal lymphadenectomy and/or chemotherapy after orchiectomy. Of the seminoma cases, only one patient (stage II cancer) died. On the other hand, only one of the non-seminoma patients in stages II and III remained alive. Since 1979, 5 patients with stage III or bulky stage II disease have been treated with the PVB protocol and 4 were evaluable. Only one patient achieved complete remission (CR) but he suffered a relapse within a short period (4 months). Three patients were partial responders and two of them achieved CR following resection of residual disease and additional VAB-6 induction. Currently, none of the patients who were treated with the initial PVB protocol alone remain in CR.