摘要
目的根据欧洲泌尿外科学会（EAU）2012版睾丸肿瘤诊疗指南概括性总结睾丸肿瘤临床治疗的最新进展,为我国睾丸肿瘤的标准化、规范化治疗提供参考.方法该指南是由多学科指南工作组共同编写完成.采用medline和embase数据库的资料以及欧洲生殖细胞肿瘤评议组的循证医学证据,由专家小组审核参考文献的价值和循证医学证据的级别,在此基础上制定推荐意见.结果具有长期随访结果的参考文献相对较为缺乏,几项正在进行的临床试验结果尚在等待中.临床治疗中心的选择至关重要,在开展临床试验的研究中心其治疗效果较好,尤其是对预后较差的非精原细胞瘤治疗效果较好.根据最近发表的研究资料来看,对临床I期的精原细胞瘤患者不再推荐放疗作为一线辅助治疗手段.推荐2009年TNM分期作为肿瘤的临床分期标准.结论该指南基于最新的科学研究结果为睾丸肿瘤患者提供标准的治疗方案.睾丸肿瘤的治疗效果较好,但是由于发病人群集中在30~50岁,治疗方案对生育功能的影响应当受到重视,而且要根据个体差异与患者本人意愿来制定相应的治疗方案.
Objective This article is a short version of the EAU testicular cancer guidelines and summarises the main conclusions from the guidelines on the management of testicular cancer. Method Guidelines were compiled by a muhidisciplinary guidelines working group. A systematic review was carried out using Medline and Embase, also taking Cochrane evidence and data from the European Germ Cell Cancer Consensus Group into consideration. A panel of experts weighted the references, and a level of evidence and grade of recommendation were assigned. Results There is a paucity of literature especially regarding longer term follow-up, and results from a number of ongoing trials are awaited. The choice of treatment centre is of the utmost importance, and treatment in reference centres within clinical trials, especially for poor-prognosis nonseminomatous germ cell tumours, provides better outcomes. For patients with clinical stage I seminoma, based on recently published data on long-term toxicity, adjuvant radiotherapy is no longer recommended as first-line adjuvant treatment. The TNM classification 2009 is recommended. Conclusions These guidelines contain information for the standardized management of patients with testicular cancer based on the latest scientific insights. Cure rates are generally excellent, but because testicular cancer mainly affects men in their third or fourth decade of life, treatment effects on fertility require careful counselling of patients, and treatment must be tailored taking individual circumstances and patient preferences into account.
出处
《昆明医学院学报》
2012年第7期79-83,共5页
Journal of Kunming Medical College
基金
欧洲泌尿外科学会临床学者基金资助项目(ESUP/CF-07-2011)
关键词
睾丸肿瘤
欧洲泌尿外科学会
放射治疗
化学治疗
Testicular cancer
European Association of Urology
Radiotherapy
Chemotherapy
