UNASSIGNED: CRAT was analysed according to age-groups: children (aged ≤11 years), adolescents (aged 12-17 years), adults (aged ≥18 years) and to chemotherapy type: CarboPEI (alternating etoposide-carboplatin/etoposide-ifosfamide) for non-metastatic germinoma; PEI (cisplatin-etoposide-ifosfamide) for standard-risk non-germinomatous GCT (NGGCT); PEI and high-dose PEI (HD-PEI), for high-risk or poorly responsive NGGCTs.
UNASSIGNED: 296 patients were assessable for CRAT: 105 children, 121 adolescents, 70 adults (max age: 41 years). Median cumulative doses/m² of chemotherapy were similar among age-groups. The proportion of germinoma over NGGCT (and accordingly use of CarboPEI chemotherapy) was higher in the adult groups (79%) versus the other two groups (62%). Delay in chemotherapy ≥7 days was noticed in 27%, 38%, and 19% of children, adolescents, and adults, respectively. Grade ≥3 haematological and non-haematological adverse events (AEs) were observed in 94%/31%, 97%/36%, and 77%/21% of children, adolescents, and adults, respectively. No toxic death was reported. Grade ≥3 AEs and delayed chemotherapies were significantly rarer in adults when compared with adolescents, even when adjusted on chemotherapy type: odds ratio: 0.1 [95%CI 0.02-0.4], and 0.2 [95%CI 0.1-0.4] in the group treated with CarboPEI.
UNASSIGNED: Adult patients can be treated safely with a chemotherapy intensive protocol, with even less toxicity than that observed in adolescents. Further work is required to understand age-related differences regarding toxicity.
■根据年龄组对CRAT进行分析:儿童(≤11岁),青少年(12-17岁),成人(≥18岁)和化疗类型:非转移性生殖细胞瘤的CarboPEI(交替使用依托泊苷-卡铂/依托泊苷-异环磷酰胺);标准风险非生殖细胞瘤GCT(NGGCT)的PEI(顺铂-依托泊苷-异环磷酰胺);PEI和高剂量PEI(HD-PEI),用于高风险或反应不佳的NGGCT。
■296名患者可进行CRAT评估:105名儿童,121名青少年,70名成年人(最大年龄:41岁)。在年龄组中,平均累积剂量/m²的化疗剂量相似。成人组(79%)与其他两组(62%)相比,NGGCT(因此使用CarboPEI化疗)的生殖细胞瘤比例更高。27%的人发现化疗延迟≥7天,38%,19%的儿童,青少年,和成年人,分别。在94%/31%中观察到≥3级血液学和非血液学不良事件(AE),97%/36%,77%/21%的儿童,青少年,和成年人,分别。没有中毒死亡的报告。与青少年相比,成人≥3级AE和延迟化疗明显罕见,即使根据化疗类型进行调整:比值比:0.1[95CI0.02-0.4],和0.2[95CI0.1-0.4]在用CarboPEI治疗的组中。
■成年患者可以通过化疗强化方案安全治疗,毒性甚至比在青少年中观察到的更小。需要进一步的工作来了解与年龄有关的毒性差异。