摘要
[目的]探讨睾丸精原细胞瘤的最佳综合治疗方法。[方法]123例经病理证实的精原细胞瘤在综合治疗后随访。[结果]①5、10年生存率Ⅰ期100%(80/80)、77 5%(62/80) ,Ⅱ期61 1%(11/18)、66 7 %(12/18) ,Ⅲ期20 0%(5/25)、0(0/25)。②Ⅰ期复发率2 5%(2/80) ,无远处转移 ,Ⅱ期复发率16 7%(3/18) ,远处转移率22 2%(4/18) ,Ⅱ期加化疗的复发率10 0%(1/10) ,远处转移率10 0%(1/10) ,Ⅲ期复发率84 0 %(21/25) ,远处转移率72 0%(18/25)。[结论]①综合治疗原则 :Ⅰ期手术加放疗 ,Ⅱ期手术加放疗加化疗 ,Ⅲ期手术加化疗加小野放疗。②腹部有淋巴结转移的不做清扫而要放疗加化疗。
To investigate the best multimodality therapy for testicular seminoma One hundred and twenty three patients with testicular seminoma pathology proved received combined treatment were followed up ①The survival rates of 5 and 10 years were 100 0% (80/80) and 77 5% (62/80) in stage Ⅰ,61 1%(11/18) and 66 7%(12/18) in stage Ⅱ,20 0%(5/25) and 0(0/25) in stage Ⅲ respectively ②Recurrent rate was 2 5%(2/80),distant metastsis rate was 0(0/80) in stage Ⅰ,16 7%(3/18) and 22 2%(4/18) in stage Ⅱ,10%(1/10) and 10 0%(1/10) in stage Ⅱ which treated by combined chemotherapy,84 0%(21/25),72 0%(18/25) in stage Ⅲ respectively [Conclusion]①The principle of combined treatment is operation plus radiotherapy for staging Ⅰ,operation plus radiotherapy plus chemotherapy for stage Ⅱ and operation plus radiotherapy with small field plus chemotherapy for stage Ⅲ.②Patients with lymph node metastases in abdomen should be treated by radiotherapy and chemotherapy,lymphadenectomy is not necessary ③In combined treatment ,we must pay attention to preservation of reproductive function and the patients ability of accepting treatment
