末梢血幹細胞移植(PBSCT)併用Vinblastin, Ifosfamide, Cisplatin(VeIP)療法を施行した再燃卵巣混合型胚細胞腫瘍の1例

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We report a case of refractory mixed germ cell tumor of the ovary. A 17-year-old woman had an emergency operation due to the rupture of a right ovarian tumor. She underwent a right salpingooophorectomy, omentectomy, appendectomy and intraperitoneal chemotherapy, being diagnosed with a malignant ovarian tumor, stage Ic. Histologic diagnosis showed mixed germ cell tumor (Yolk sac tumor, dysgerminoma and embryonal carcinoma). Her preoperative prognosis was poor because of high serum alpha fetoprotein (AFP). She received 6 courses of chemotherapy consisting of peplomycin, etoposide and carboplatin (PEP), and AFP was decreased to the normal range. Her AFP reincreased and a tumor in the anterosacral area was found two months after the initial treatment. Because PEP was not effective, a new regimen consisting of vinblastin, ifosfamide and cisplatin (VeIP) was selected as a salvage therapy. Since she suffered from severe myelosuppression, she underwent peripheral blood stem cell transplantation (PBSCT) at the time of the 4th, 5th and 6th courses of VeIP. This regimen resulted in decreasing the tumor markers to within the normal range, and the tumor could be completely removed surgically. Unfortunately, pathology revealed viable cells of yolk sac tumor and embryonal carcinoma remained. High dose chemotherapy (HDC) combined with PBSCT was planned, but a severe neuromuscular side effect of the chemo-therapy caused us to give up further therapy. In spite of using a high total dose of platina (carboplatin; 3,15Omg, cisplatin; 1,225mg), she died from the disease.
社団法人日本産科婦人科学会の論文
1999-12-01

末梢血幹細胞移植(PBSCT)併用Vinblastin, Ifosfamide, Cisplatin(VeIP)療法を施行した再燃卵巣混合型胚細胞腫瘍の1例

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