Department of Radiation Oncology, Tübingen University Hospital, Hoppe-Seyler-Str. 3, 72079, Tübingen, Germany.
J Cancer Res Clin Oncol. 2010 Feb;136(2):227-32. doi: 10.1007/s00432-009-0653-x. Epub 2009 Aug 14.
The extent and duration of routine follow-up after paraaortic (PA) radiotherapy for stage I seminoma remain controversial in terms of efficacy, costs of technical investigations and long-term morbidity.
To analyze the current literature assessing routine follow-up after PA radiotherapy for stage I seminoma.
We identified all published reports on PA radiotherapy for stage I seminoma (1986-2005). We analyzed time patterns of recurrence, sites and methods of detection of relapse, and follow-up programs used.
We identified 11 publications reporting outcome in 2,280 patients. Median time to recurrence in 80 relapsing patients was 15.5 months. Less than 10% of recurrences were diagnosed beyond the third year of follow-up. Isolated locoregional or distant recurrence was observed in 52 and 20 patients, respectively, without significant difference in median time to relapse. 19 out of 43 recurrences with reported method of detection of relapse were diagnosed by routine technical investigations. There was no significant difference in time to relapse between those patients followed with low volume as compared to high-volume imaging protocols.
Our data suggest that technical investigations in posttreatment surveillance should be restricted to the first 3 years of follow-up. Furthermore, surveillance programs with a high volume of imaging apparently do not lead to earlier detection or less advanced stage at the time of relapse as compared to protocols with low volume imaging.
在 I 期精原细胞瘤的腹主动脉旁（PA）放疗后，常规随访的范围和时间在疗效、技术检查成本和长期发病率方面仍存在争议。
分析评估 I 期精原细胞瘤 PA 放疗后常规随访的当前文献。
我们确定了所有关于 I 期精原细胞瘤 PA 放疗的已发表报告（1986-2005 年）。我们分析了复发的时间模式、复发的部位和检测方法，以及使用的随访方案。
我们确定了 11 项报告 2280 例患者结果的出版物。80 例复发患者的中位复发时间为 15.5 个月。随访 3 年后，不到 10%的复发被诊断。分别观察到 52 例和 20 例局限性或远处孤立性复发，复发时间无显著差异。43 例有报道的复发检测方法的复发中，19 例通过常规技术检查诊断。与采用高体积成像方案相比，采用低体积成像方案的患者复发时间无显著差异。
我们的数据表明，在治疗后监测中，技术检查应仅限于随访的前 3 年。此外，与高体积成像方案相比，高体积成像监测方案并未导致更早的检测或复发时更晚期的疾病。
