To investigate the outcomes of children, adolescents, and young adults (AYAs) with malignant ovarian germ cell tumors (MOGCTs), we analyzed the data of 61 patients aged ≤39 years diagnosed with MOGCT between 2006 and 2022. Among 59 patients who received chemotherapy after initial diagnosis, 57 received BEP (standard dose of bleomycin with 30 units per week,n= 13) or bEP (reduced dose of bleomycin with 15 units/m2on day 1,n= 44). The 5-year overall survival (OS) and event-free survival (EFS) rates were 98.3% and 84.9%, respectively. Reduced bleomycin dose did not adversely affect survival. Normalization of tumor markers within 3 months after surgery was significantly associated with better EFS (p< 0.01). Of the 59 surviving patients, 8 experienced surgery-related menopause, while 49 demonstrated menstrual recovery. After completion of chemotherapy, there was no significant difference in pulmonary function regarding bleomycin dose, and no overt nephrotoxicity. Approximately 60% and 25% of survivors experienced peripheral neuropathy at the end of chemotherapy and after 1 year, respectively (p< 0.01). Children and AYAs with MOGCT have favorable survival rates with minimal long-term toxicity, which are not influenced by a reduced bleomycin dose. Rapid normalization of tumor markers is associated with improved outcomes.
为探究儿童、青少年及年轻成人恶性卵巢生殖细胞肿瘤患者的临床结局，本研究分析了2006年至2022年间确诊的61例年龄≤39岁患者资料。在59例初诊后接受化疗的患者中，57例采用BEP方案（标准剂量博来霉素每周30单位，n=13）或bEP方案（减量博来霉素第1天15单位/平方米，n=44）。5年总生存率和无事件生存率分别为98.3%和84.9%。博来霉素减量未对生存率产生负面影响。术后3个月内肿瘤标志物恢复正常与更好的无事件生存率显著相关（p<0.01）。在59例存活患者中，8例出现手术相关绝经，49例月经功能恢复。化疗结束后，不同博来霉素剂量组间肺功能无显著差异，且未出现明显肾毒性。约60%和25%的生存者在化疗结束时及1年后出现周围神经病变（p<0.01）。儿童及年轻成人恶性卵巢生殖细胞肿瘤患者生存预后良好，长期毒性反应轻微，且不受博来霉素减量影响。肿瘤标志物的快速正常化与改善的临床结局相关。
肿瘤(癌症)患者之家