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Герміногенна пухлина яєчка · BEP (bleomycin + etoposide + cisplatin, germ cell tumor)
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
Аудит запису бази знань. Попередній клінічний вміст: це не призначення. Онколог має перевірити джерела, застосовність і статус рецензування. Повні правила та обмеження доступні в YAML.
Джерельний YAML: повний запис
Нотатки
Testicular GCT is unique — curative even at metastatic stage for most patients. Post-BEP residual mass management: seminoma >3cm → PET-guided (FDG-avid → biopsy/resection; FDG-negative → observe); NSGCT >1cm → RPLND for residual teratoma resection. Surveillance after good-risk GCT: CT CAP q3-4 months year 1, then q6 months year 2-3; markers q1-2 months year 1. 2L salvage: TIP (paclitaxel + ifosfamide + cisplatin) or VIP (vinblastine + ifosfamide + cisplatin) for cisplatin-sensitive relapse; high-dose chemotherapy + ASCT at specialized centers for multiply relapsed/refractory GCT.
Докази для окремих тверджень
Цитати стосуються лише наведених тверджень і меж застосування. Вони не встановлюють клінічного схвалення всього запису.
Bleomycin exposure warrants perioperative pulmonary-risk assessment. Label precautions favor lower oxygen concentrations, but observational evidence does not establish a universal FiO2 ceiling. Anesthesia should balance pulmonary risk with adequate oxygenation; a fixed limit must not cause inadequate oxygenation.
Perioperative oxygen management after bleomycin only; no verification of other BEP dosing or supportive-care statements.
SRC-BLEOMYCIN-US-LABEL SRC-AAKRE-BLEOMYCIN-PERIOPERATIVE-2014 SRC-BLEOMYCIN-OXYGEN-MONITORING-1984
Bleomycin label pulmonary adverse reactions; Aakre 2014 Results/Discussion; PMID 6200191 abstract.
Primary G-CSF prophylaxis is not universally required for metastatic testicular BEP; clinicians may choose it to maintain dose intensity. Supportive therapy follows individual assessment and institutional protocol.
G-CSF supportive-care selection only; no approval of anticancer dosing, renal adjustments or treatment eligibility.
SRC-EVIQ-TESTICULAR-BEP-320
eviQ 320 v9 treatment schedule footnote ** and supportive therapy defaults paragraph.
New cough or dyspnea during bleomycin treatment requires assessment for pulmonary toxicity; HRCT is preferred when toxicity is suspected. PFT/DLCO is adjunctive, is not a sole automatic stop rule and does not guarantee prevention of pulmonary toxicity.
Pulmonary symptom assessment and role of PFT/DLCO only; no blanket validation of other BEP claims.
SRC-BLEOMYCIN-UK-BEST-PRACTICE-2018
British Journal of Cancer best-practice guideline: role of PFTs and symptom monitoring sections.
Bleomycin unit systems must be identified explicitly. The eviQ equivalence is 1.5 USP units = 1500 International Units, so 30 USP units = 30000 International Units. US product vials are labelled 15 or 30 units of Bleomycin for Injection USP. Do not interpret milligram activity as a general mg-by-weight conversion.
Unit nomenclature and equivalence only; not individualized dosing, schedule selection, cumulative-risk elimination or whole-record clinical approval.
SRC-BLEOMYCIN-US-LABEL SRC-EVIQ-TESTICULAR-BEP-320
US label Description/How supplied; eviQ 320 treatment schedule bleomycin equivalence footnote.
Де використовується
Algorithms
ALGO-GCT-METASTATIC-1L - ALGO-GCT-METASTATIC-1LALGO-GCT-SALVAGE-2L - ALGO-GCT-SALVAGE-2L