PDF(Pubmed)
Abstract：
BACKGROUND: Germinal testicular tumors are the most common malignant neoplasm in men around 20 to 34 years. Even though they are unusual, they have increased incidence in the last decade; they have an excellent prognosis and overall survival at five years, approximately 95%. Divergent data exists regarding treatment options in patients with first, second, and third relapses with conventional therapy. Some studies describe the possible benefit of using high-dose chemotherapy associated with a bone marrow transplant with variable results.
METHODS: The present study describes clinical outcomes, clinical response, mortality, overall survival, and progression-free survival to two years in a group of patients with germinal malignant tumors, seminoma versus non-seminomatous with evidence of progression of the disease at first, second, or third conventional chemotherapy regimens, and who received high dose chemotherapy and bone marrow transplantation at the National Cancer Institute between 2010 and 2021.
RESULTS: A retrospective observational study of case series showed that 57% of patients in third-line therapy received high-dose chemotherapy and bone marrow transplantation, with progression disease median time from diagnosis more than two years. Patients in the post-graft period presented infectious complications (71%). The most common were febrile neutropenia (29%) with a mortality rate of 71% (n=5), progression-free survival of 2.3 months, and overall survival of 7.4 months.
CONCLUSIONS: These results show that in this group of patients, regimens with high-dose chemotherapy associated with bone marrow transplants, have a worse prognosis compared to other cohorts of patients, and may not be the best candidates for this rescue therapy.
METHODS: The present study describes clinical outcomes, clinical response, mortality, overall survival, and progression-free survival to two years in a group of patients with germinal malignant tumors, seminoma versus non-seminomatous with evidence of progression of the disease at first, second, or third conventional chemotherapy regimens, and who received high dose chemotherapy and bone marrow transplantation at the National Cancer Institute between 2010 and 2021.
RESULTS: A retrospective observational study of case series showed that 57% of patients in third-line therapy received high-dose chemotherapy and bone marrow transplantation, with progression disease median time from diagnosis more than two years. Patients in the post-graft period presented infectious complications (71%). The most common were febrile neutropenia (29%) with a mortality rate of 71% (n=5), progression-free survival of 2.3 months, and overall survival of 7.4 months.
CONCLUSIONS: These results show that in this group of patients, regimens with high-dose chemotherapy associated with bone marrow transplants, have a worse prognosis compared to other cohorts of patients, and may not be the best candidates for this rescue therapy.
摘要：
背景：生发睾丸肿瘤是20~34岁男性中最常见的恶性肿瘤。即使它们不寻常，在过去的十年中，它们的发病率增加；它们在五年时具有良好的预后和总体生存率，约95%。关于患者的治疗选择存在不同的数据，第二,和第三复发与常规治疗。一些研究描述了使用大剂量化疗与骨髓移植相关的可能益处，结果可变。
方法：本研究描述了临床结果，临床反应，死亡率,总生存率,一组生发恶性肿瘤患者的无进展生存期为两年，精原细胞瘤与非精原细胞瘤，首先有疾病进展的证据，第二,或第三种常规化疗方案，并在2010年至2021年期间在美国国家癌症研究所接受了高剂量化疗和骨髓移植。
结果：一项病例系列的回顾性观察性研究表明，57％的三线治疗患者接受了大剂量化疗和骨髓移植，从诊断开始的中位疾病进展时间超过两年。移植后患者出现感染性并发症（71％）。最常见的是发热性中性粒细胞减少症（29％），死亡率为71％（n=5）。无进展生存期2.3个月，总生存期为7.4个月。
结论：这些结果表明，在这组患者中，与骨髓移植相关的大剂量化疗方案，与其他患者相比，预后较差，并且可能不是这种抢救疗法的最佳候选人。
方法：本研究描述了临床结果，临床反应，死亡率,总生存率,一组生发恶性肿瘤患者的无进展生存期为两年，精原细胞瘤与非精原细胞瘤，首先有疾病进展的证据，第二,或第三种常规化疗方案，并在2010年至2021年期间在美国国家癌症研究所接受了高剂量化疗和骨髓移植。
结果：一项病例系列的回顾性观察性研究表明，57％的三线治疗患者接受了大剂量化疗和骨髓移植，从诊断开始的中位疾病进展时间超过两年。移植后患者出现感染性并发症（71％）。最常见的是发热性中性粒细胞减少症（29％），死亡率为71％（n=5）。无进展生存期2.3个月，总生存期为7.4个月。
结论：这些结果表明，在这组患者中，与骨髓移植相关的大剂量化疗方案，与其他患者相比，预后较差，并且可能不是这种抢救疗法的最佳候选人。
