Bleomycin, Etoposide and Cisplatinum (BEP) Chemotherapy for Metastatic Germ Cell Tumours: Treatment Outcomes at UKM Medical Centre, Malaysia

Azrif, Muhammad; Leong, Yu Kong; Aslan, Nik Muhammad; Fong, Kua Voon; Ismail, Fuad

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자료유형: 학술저널

저자정보: Azrif, Muhammad (Department of Radiotherapy & Oncology, UKM Medical Centre) Leong, Yu Kong (Department of Radiotherapy & Oncology, UKM Medical Centre) Aslan, Nik Muhammad (Department of Radiotherapy & Oncology, UKM Medical Centre) Fong, Kua Voon (Department of Radiotherapy & Oncology, UKM Medical Centre) Ismail, Fuad (Department of Radiotherapy & Oncology, UKM Medical Centre)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제13권 제6호

발행연도: 2012.1

수록면: 2,467 - 2,471 (5page)

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Introduction: Although bleomycin/etoposide/cisplatinum (BEP) chemotherapy is established as the standard treatment for germ cell tumours, it requires significant experience in administration and toxicity management to maintain optimal dose intensity. A retrospective review of 30 patients was conducted at UKMMC to study treatment outcomes. Methods & Materials: Patients with GCTs and treated with at least two cycles of BEP chemotherapy between January 2003 and Oct 2009 were eligible for this study. Patients received 4-6 cycles of bleomycin 30,000IU IV D1, D8 & D15 and either etoposide $100mg/m^2$ IV D1-D5 and cisplatin $20mg/m^2$ IV D1-D5 (5 day BEP regimen) or etoposide $165mg/m^2$ D1-D3 and cisplatin $50mg/m^2$ D1-3 (3 day BEP regimen) every three weeks per cycle. All patients received prophylactic granulocyte colony-stimulating factor (GCSF) from days 6 to 10 of each cycle. The overall response rates, 2 year progression-free survival and overall survival of the whole cohort were assessed. Results: Thirty patients fulfilled the inclusion criteria. Non-seminomatous GCTs comprised 93.3% of cases and gonadal and mediastinal primary sites were the most common. Sixty percent were classified as IGCCCG poor risk disease. Median follow-up was 26.6 months. The overall response rate (CR+PR) was 70%. The two year PFS and OS were 70% and 66%. There was a significant difference in terms of the overall response rate (85% vs 40%, p = 0.03) and in PFS (94.7% vs 50%, p = 0.003) between gonadal and extragonadal primary sites. Conclusion: It is possible to achieve outcomes similar to those in international clinical trials with close monitoring and good supportive care of patients undergoing BEP chemotherapy. There is a strong argument for patients with IGCCCG poor prognosis disease to be treated in specialist tertiary centres to optimize treatment outcomes.

#Germ cell tumour #BEP chemotherapy #prognosis #Malaysia

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