臨床泌尿器科68巻11号

2014年10月発行

特集 泌尿器科医のためのクリニカル・パール（1）

転移を有する進行性精巣腫瘍治療のクリニカル・パール

著者： 中村晃和¹ 大石正勝¹ 上田崇¹ 三木恒治¹

所属機関： ¹京都府立医科大学大学院医学研究科泌尿器外科学

ページ範囲：P.856 - P.862

要旨　進行性精巣腫瘍の治療は，IGCC分類に基づき，good prognosis群ではBEP療法3コースまたはEP療法4コースが標準，poor prognosis群では，BEP療法を4コースが標準である。腫瘍マーカーとしてhCGを測定する場合は，単位がmIU/mLのものを測定する必要がある。肺機能低下の疑われる症例では，VIP療法も考慮される。導入化学療法としての大量化学療法は，RCTが行われた結果，その有用性が証明されず，現在のところ標準的な導入化学療法とはいえない。初回化学療法で寛解が得られない場合は，救済化学療法を行い，腫瘍マーカー正常化後は残存腫瘍を切除する。

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