A single institution, retrospective study of treatment experience in primary mediastinal germ cell tumors: elucidating the significance of systemic chemotherapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Primary malignant germ cell tumors (GCTs) of mediastinum are rare neoplasms. We introduce our institutional experience in managing patients with primary malignant GCTs of the mediastinum, focusing on the analysis of therapeutic modalities.</p><p><b>METHODS</b>A retrospective review was done in 39 consecutive patients with mediastinal malignant GCTs treated in our institution between 1991 and 2007.</p><p><b>RESULTS</b>A total of 39 patients were enrolled in this study with a median age of 27 years. The 5-year overall survival (OS) and progression-free survival (PFS) rates of the whole population were 60.2% and 57.7%, respectively. Stratified by the histology, 18 patients (46.2%) had seminoma and 21 patients (53.8%) had nonseminomatous germ cell tumors (NSGCTs). The 5-year OS rate of patients with seminoma was 87.4% as compared with 36.7% in patients with NSGCTs (P = 0.0004). The 5-year PFS rate was also significantly higher in seminoma patients (87.4% vs. 31.6%, P = 0.003). For 19 patients with NSGCTs managed with multi-modality treatment, chemotherapy exposure appeared to impact the prognosis. The 5-year OS rate was 44.9% in patients with chemotherapy exposure as compared with 20.0% in patients without it (P = 0.43).</p><p><b>CONCLUSION</b>Our study confirmed the significance of systemic chemotherapy in the treatment of primary mediastinal GCTs.</p>

Clinical analysis of 32 cases of primary malignant germ cell tumors in mediastinum / 肿瘤

Objective: To analyze clinical features, treatment and prognosis of primary malignant germ cell tumors (MGCT) of mediastinum. Methods: Thirty-two patients with primary malignant germ cell tumors of mediastinum received multi-modality treatment such as surgery, radiotherapy and chemotherapy. There were 18 patients with seminomas and 14 patients with nonseminomatous germ cell tumors. Results: For patients with nonseminomatous germ cell tumors the median survival time was 32.4 months and the median progression-free survival (PFS) time was 18 months. Both the five-year disease free survival rate and the total survival rate were 28.6%. For patients with seminomas the five-year disease free survival rate was 83.3% and the total survival rate was 85.6%. And the median survival time and the progression-free survival time could not be calculated. Both the median survival time and the PFS time were longer in patients with seminomas than those with nonseminomatous germ cell tumors (P = 0. 0014 and 0. 0007, respectively). Conclusion: Multi-modality treatment for patients with primary mediastinal seminomas achieves better clinical outcomes. Our results are in accordance with others work reported in the literature. The therapeutic efficacy for nonseminomatous germ cell tumors should be improved. Nonseminomatous germ cell tumor is an important prognostic factor for mediastinal malignant tumors.

Experience of gemcitabine plus cisplatin chemotherapy in 52 patients with head and neck cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and toxicity of combination chemotherapy using gemcitabine plus cisplatin for recurrent and/or metastastic head and neck cancer patients.</p><p><b>METHODS</b>Fifty-two patients with recurrent or metastatic head and neck cancer were treated by gemcitabine 1000 mg/m(2) on D1, 8 and cisplatin 25 mg/m(2) on D1 approximately 3 every 21 days as one cycle.</p><p><b>RESULTS</b>Of 52 assessable patients, 3 (5.8%) showed complete response and 19 (36.5%) partial response with an overall response rate of 42.3% (22/52). Median time to progression was 5.0 months, and 1-year survival was 43.4% with a median survival time of 9.9 months. Of 32 previously treated patients by cisplatin-containing regimen, 2 patients (6.3%) gave complete response and 11 (34.4%) partial response with an overall response rate of 40.6% (13/32). Median time to progression was 3.4 months, and 1-year survival was 29.2% with a median survival time of 8.3 months. Toxicity mainly included grade 1/2 myleosuppression, rash and nausea/vomiting.</p><p><b>CONCLUSION</b>Gemcitabine plus cisplatin chemotherapy is safe and effective for patients with recurrent and/or metastastic head and neck cancer.</p>