What are the treatment options for teratoma

Once a teratoma is diagnosed, early surgical resection is necessary to prevent the malignant transformation of benign teratoma due to delayed surgery, and to prevent infection, rupture, bleeding and complications of the tumor. The key point of teratoma surgery is to completely remove the tumor. For ovarian and testicular tumors, one ovary or testicle should be removed. For sacrococcygeal teratoma, it is important to remove the coccyx at the same time to avoid residual pluripotent cells and tumor recurrence. The following is a treatment plan for teratoma.

1. Surgical treatment: Once a teratoma is diagnosed, surgery should be performed as soon as possible. For cases diagnosed as malignant tumors, chemotherapy should be given before surgery to create conditions for elective surgery.

2. Chemotherapy For mixed teratomas, only chlorambucil (CI, B) can be used, at 0.1 mg/(kgd) orally for 12 weeks. For malignant teratomas, chemotherapy should be given after surgical resection. Commonly used chemotherapy regimens are as follows:

POMB/ACE alternation therapy:

POMB regimen: vincristine (VCR) 1.5 mg/m2, intravenous injection, day 1; methotrexate (MTX) 100 mg/m2, intravenous drip (continuous for 12 hours), day 1; calcium folinate (CF) rescue, 15 mg, once/12 hours, days 2 and 3; bleomycin (BLM) 10-20 mg/m2, intravenous injection (continuous for 24 hours), day 3; cisplatin (DDP) 60 mg/m2, intravenous drip, day 4; one course of treatment is 2 weeks.

ACE regimen: etoposide (VP16) 100 mg/m2, intravenous injection, days 1 to 5; actinomycin D (ACD) 0.45 mg/m2, intravenous injection, days 3 to 5; cyclophosphamide (CTX) 500 mg/m2, intravenous injection, day 5; 2 weeks as a course of treatment. After POMB2 courses, PONfB and ACE are used alternately. The total course of treatment is 1 year.

DVB regimen: DDP 20 mg/m2, intravenous injection, days 1 to 5; vinblastine (VLB) 0.15-0.2 mg/kg, intravenous injection, days 1 and 2; BLM 10-20 mg/m2, intravenous injection, days 1, 8, and 15. One course of treatment is 3 weeks.

Surgery after 4 courses of treatment, followed by CA chemotherapy:

CA regimen: CTX 500 mg/m2, intravenous injection, day 1; doxorubicin (ADR) 50 mg/m2, intravenous injection, day 1. For patients with residual tumor, 10 times/3 weeks; for patients without residual tumor, 5 times/3 weeks.

3. Immunotherapy transfer factor, intramuscular injection 1-2 times a week, 1 vial each time. Or use short anaerobic bacteriocin at the same time, starting from 0.1ml/time, once a week, increasing by 0.1ml each time, until 2ml/time, for 2 years.

4. Radiotherapy is currently used in cases of malignant teratoma with microscopic or macroscopic residues.

Prognosis of teratoma: The prognosis of teratoma is closely related to factors such as age, clinical classification, incidence of malignant transformation, early or late treatment, and treatment results.