Treatment of mediastinal malignant germ cell tumors

概要

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Malignant germ cell tumors of mediastinal origin can be classified as to seminomas and non-seminomatous germ cell tumors (NSGCT) just as of testicular origin. The former are generally highly sensitive to radiation therapy, and then can be expected of relatively better prognosis. The latter generally have a low sensitivity to radiation therapy, and have been expected so far to have a quite poor prognosis even after the introduction of multi-drug chemotherapy based on cis-platinum (CDDP). In this paper, we analysed on 16 cases of mediastinal malignant germ cell tumors of our own with reference on the literature, leading to the following working guideline for the management of those tumors.<BR>1. When there is a suspicion of a malignant germ cell tumor, diagnostic assessment should be made through CT, serum markers such as AFP and HCG, and if necessary through biopsy.<BR>2. When either of the markers is positive, or histological diagnosis is determined through biopsy as a malignant germ cell tumor, first choice to do is CDDP based chemotherapy in an attempt for the tumor to be completely resected at the subsequent surgical treatment.<BR>3. When neither of the marker is negative and the tumor is expected to be surgically completely removed, operation is to be forwarded.<BR>4. Following operation, either chemotherapy, radiotherapy, or their combined therapy is to be added by necessity.
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