摘要
目的:分析Ⅰ、ⅡA/ⅡB期单纯精原细胞瘤的远期治疗效果并探讨其治疗策略.方法:1986~2000年本院收治的Ⅰ、ⅡA/ⅡB期单纯精原细胞瘤107例,术后单纯放疗73例(68.2%),单纯化疗20例(18.7%),放、化疗联合10例(9.3%),未接受治疗4例(3.7%).复发共7例,均予以化疗,残留者辅以放疗.结果:(1)Ⅰ期与ⅡA/ⅡB期单纯放疗的总生存率(OS)及10年无瘤生存率(DFS)分别为100%(61/61)、95.1%(58/61)、100%(12/12)、100%(12/12),而单纯化疗患者分别为100%(14/14)、100%(14/14)、66.7%(4/6)、66.7%(4/6);(2)全组复发率为6.5%(7/107),再次治疗的治愈率为85.7%(6/7);(3)远期并发症发生率为2.7%(2/73).结论:(1)Ⅰ期及ⅡA/ⅡB期单纯精原细胞瘤术后可首选放疗;(2)为尽量避免放疗远期并发症,可选择部分病人行单独的腹主动脉旁野照射;(3)Ⅰ期也可单纯化疗;(4)复发病人经积极救治,仍可获较高的治愈率.
Objective:To analyze the long-term results of Stage Ⅰ and ⅡA/ⅡB testicular seminoma, and discuss the strategies of treatment. Methods :107 cases Stage Ⅰ and ⅡA/ⅢB testicular seminoma were observed in our hospital from 1986 to 2000. All had been operated by means of orchidectomy, of which 73 cases(68.2% ) received radiotherapy only(RO) , 20( 18.7% ) chemotherapy only(CO) , 10(9. 3% ) radiochemotherapy(RC) and 4(3.7% ) no treatment(NT). All the 7 relapses were treated by chemotherapy, completed by radiotherapy if residual. Results:(1) The overall survival rates(OS) and 10-year disease-free-survival rates (DFS) of RO were 100% (61/61) , 95.1% (58/61) for Stage Ⅰ and 100% (12/12) , 12% (12/12) for Stage ⅡA/ⅡB, While those of CO were 100% (14/14) , 14% (14/14) and 66. 7% (4/6) , 66. 7% (4/6) , respectively. (2) The overall relapse rate was 6. 5% (7/ 107) , and a cure rate of 85.7% (6/7) was obtained after re-treated. (3) The rate of late effects was 2. 7% ( 2/73 ). Conclusions : (1) Radiotherapy should be considered as a standard strategy for Stage Ⅰ and ⅡA/ⅡB testicular seminoma. (2) To avoid the late effects, para-aortic irradiation only may be reasonable for some patients. (3) CO has been proved to be an effective and feasible strategy for Stage I testicular seminoma. (4) In case of relapse, a good cure rate could be achieved by a salvage treatment.
出处
《临床肿瘤学杂志》
CAS
2005年第6期606-609,共4页
Chinese Clinical Oncology
关键词
睾丸精原细胞瘤
放射治疗
化疗
Testicular seminoma
Radiotherapy
Chemotherapy