晚期睾丸非精原生殖细胞肿瘤预后与辅助化疗疗程的关系:附41例综合治疗经验总结

Relationship between prognosis and chemotherapy cycles of advanced nonseminomatous germ cell testis cancer(Review of the experience in the multitreatment of 41 cases)

目的：总结中山大学肿瘤防治中心泌尿外科过去近10年间晚期睾丸非精原生殖细胞肿瘤（NSGCT）综合治疗临床疗效,对比分析临床晚期NSGCT不同治疗方案疗效与化疗疗程的关系。方法：回顾分析1999~2008年近10年间在中山大学肿瘤防治中心泌尿外科治疗的所有晚期NSGCT患者的临床资料。描述分析临床晚期NSGCT综合治疗临床疗效,比较分析是否行腹膜后淋巴结清扫术（RPLND）的患者3程以上BEP方案化疗与3程及以下化疗疗效的差异,统计学方法采用Kaplan-Meier。结果：RPLND术后行BEP方案≤3程与〉3程化疗预后的差异无统计学意义（P=0.623）。未行RPLND的患者〉3程化疗预后优于≤3程化疗（P=0.021）。结论：Ⅱ/Ⅲ期NSGCT化疗前接受RPLND可减少化疗疗程从而减轻化疗不良反应。

Objective：To retrospectively review the experience of multitreatment of patients with advanced testicular nonseminomatous germ cell tumor（NSGCT）in the department of urology in Sun Yat-sen university cancer center in the past ten years and compare the relationship between different therapy and chemotherapy treatment among the patients with advanced NSGCT.Method：A retrospective chart review of all patients with advanced NSGCT undergoing multi-disciplinary approach was analyzed from 1999 to 2008.We described clinical outcome and analyzed the therapy effects among the patients who received more or less than three cycles of chemotherapy after retroperitoneal lymphnode dissection（RPLND）or not.The statistics modal was Kaplan-Meier methods.Result：The relapse-free survival of patients who delivered with more than three cycles of chemotherapy after RPLND and those patients received less than three cycles of chemotherapy group after RPLND had no significant statistics difference（P =0.623）.However,the chemotherapy of more than three cycles had higher survival than less than three cycles of chemotherapy in patients who didn＇t receive RPLND（P =0.021）.Conclusion：RPLND can reduce the cycle of BEP chemotherapy so as to reduce the risk of side effects of chemotherapy for those patients with stageⅡ/Ⅲ NSGCT.