Ramakrishnan S, Champion A E, Dorreen M S, Fox M
Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK.
Clin Oncol (R Coll Radiol). 1992 Sep;4(5):284-6. doi: 10.1016/s0936-6555(05)81100-8.
Experience with the management of 128 patients with Stage I testicular seminoma over a 10-year period, 1980-1989, is presented. Fifty-six patients were treated with post-orchidectomy radiation therapy and 72 patients were put on surveillance. Patients thought to be at higher risk of relapse were generally treated with radiotherapy. There have been no tumour related deaths in this series; 5.4% of the irradiated group and 18% of patients on surveillance have relapsed to date. All relapses have been salvaged with further therapy and are currently in complete remission. In this interim analysis, surveillance appears to be a safe alternative to adjuvant radiation therapy provided regular, prolonged follow-up can be ensured. Surveillance is, however, time consuming and resource demanding, and should be undertaken only as part of a formal clinical study. Adjuvant post-orchidectomy radiotherapy should be considered the treatment of choice until further long-term data are available.
本文介绍了1980年至1989年十年间128例I期睾丸精原细胞瘤患者的治疗经验。56例患者接受了睾丸切除术后放射治疗，72例患者接受了观察。被认为复发风险较高的患者通常接受放射治疗。该系列中没有与肿瘤相关的死亡病例；迄今为止，放射治疗组有5.4%的患者复发，观察组有18%的患者复发。所有复发病例均通过进一步治疗得到挽救，目前处于完全缓解状态。在这项中期分析中，如果能够确保定期、长期的随访，观察似乎是辅助放射治疗的一种安全替代方案。然而，观察既耗时又需要资源，并且应该仅作为正式临床研究的一部分进行。在获得进一步的长期数据之前，睾丸切除术后辅助放射治疗应被视为首选治疗方法。
