Germ hücreli testis kanserlerinde 78 aylık izlem ve kemoterapi sonuçları

Abstract

ÖZET 1987-1994 yılları arasında GATA Tıbbi Onkoloji kliniğinde 65 hastaya testis kanseri tanısı konuldu. Kemoterapisiz takip edilen 10 ve takip dışı kalan 17 olgu değerlendirilmeye alınmadı. Değerlendirmeye alman 38 hastanın yaş ortalaması 21,89±3,03 (18-37) idi. Kemoterapi gören olguların %13 (5) 'ti Evre A, %53 (20) 'ü Evre B ve %34 (13) 'ü Evre C'dir. Olguların 7'si Seminom 31'i Nonseminom testis tümörüdür. 31 (%82) olguya PVB (Cisplatin, Vinblastin, Bleomycine), 3 (%0.8) olguya BEP (Bleomycin, Etoposide, Cisplatin) ve 3 olguya da değişik kombinasyon kemoterapileri uygulandı. Birincil kemoterapiden sonra nükseden 15 (%40) olguya VIP (Etoposide, tfosfamide, Cisplatin) salvage kemoterapileri verildi. 5 olguda (%14) `Second Look Laparatomy` yapıldı. 1 olguda matürteratom, 2 olguda karsinom metastazı, 1 olguda reaktif hiperplazi, 1 olguda nekroz saptandı. Olguların maksimum takip süresi 78 ay, medyan takip süresi ise 14.49 aydır. Toplam sağkalım olasılığı %69.22 olarak bulundu. 11 olguda (%29) tedaviye bağlı ciddi toksik etkiler gözlendi. Bu sonuçların diğer gelişmiş merkezlerin sonuçlarına büyük benzerlikler gösterdiği söylenebilir. 32

SUMMARY THE RESULTS OF 7 8 -MONTH FOLLOW-UP AND CHEMOTHERAPY IN PATIENTS WITH TESTICULAR GERM CELL CANCER Between 1987 and 1994, 65 patients were diagnosed to have testicular cancer at Gülhane Military Medical Academy, department of medical oncology. Ten patients who haven't undergone chemotherapy and 17 patients out of control were excluded. The mean age of 38 patients who were investigated was 21.89±3.03 (range: 18-37). In patients who had chemotherapy; 13 % was stage A, 53 % was stage B and 34 % was stage C. Seven patients were seminoma and 31 patients were nonseminomatous testicular cancer. PVB regimen (cisplatin, vinblastin, bleomycine) was given in 31 patients, BEP (bleomycin, etopside, cisplatin) was given in 3 patients and various other combination chemotherapy regimens were given in 3 patients. The VIP regimen (etoposide, ifosfamide, cisplatin) as a salvage regimen was administered in 15 patients who relapsed after primary chemotherapy. Second-look laparatomy done in five cases revealed. One mature teratom, two metastatic carcinomas, one hyperplasia and a necrosis case. The maximum follow-up and median follow-ups were 78 and 14.49 months respectively. The overall survival rate was 69.22 %. Severe side-effects were observed in 11 (29 %) patients. In conclusion, it may be said that our results are similar to that of the results of other advanced centers. 33