原发性纵隔恶性生殖细胞肿瘤临床研究

目的探讨原发纵隔恶性生殖细胞肿瘤的诊治与预后。方法本院共收治原发纵隔恶性生殖细胞肿瘤18例,其中男性15例,女性3例,中位年龄23岁(15～51岁);精原细胞瘤6例,非精原细胞瘤12例。结果 13例行姑息性手术切除,5例接受了活检。多数病人接受了术后以顺铂为主的联合化疗,15例同时接受术后放疗。6例精原细胞瘤中4例生存,1例死亡。12例非精原细胞瘤中11例死亡,中位生存时间为13个月(4～45个月),仅1例治疗后45个月无瘤生存。结论原发纵隔恶性生殖细胞瘤为一种高度恶性肿瘤,精原细胞瘤对术后以顺铂为主的联合化疗和放疗疗效好,而非精原细胞瘤恶性度高,治疗疗效和预后差。

Primary Malignant Germ Cell Tumors of the Mediastinum: An Analysis of 18 Cases

Objective To evaluate the effect of treatment and overall outcome of primary malignant germ cell tumors of the mediastinum with currently available treatment strategies.Methods 18 patients with primary malignant germ cell tumors of the mediastinum were analyzed.The pa- tients'age ranged from 15 to 51 years(median,23 years),15 male,3 female.Twelve patients lind a nonseminomatous germ cell tumor(GCT), and six patients had a seminomatous histology.Results Of the 18 patients,thirteen patients received a partial tumor resection,five patients had a biopsy.Most of patients received post-operation platinum-based induction chemotherapy,and 15 patients with radiotherapy.Four of six pri- mary seminoma patients were alive,and one died of the disease.In contrast to 12 nonseminoma patients,11 patients were died of tumor relapse and distant metastasis,the median survival term was 13 months(445 months),only 1 patient survived 45 months with the disease free.Conclu- sion Primary mediastinal germ cell tumor is a high malignant tumor,patients with pure seminoma had a good prognosis with treatment combined platinum-based induction chemotherapy with or without radiotherapy;but for patients with nonseminomas,the outcome is very poor.