Thomas G
Department of Radiation Oncology Toronto-Bayview Regional Cancer Centre, Ontario, Canada.
Prog Clin Biol Res. 1990;357:217-24.
A series of controversies in the management of testicular seminoma were raised in this paper. Some of these issues have been discussed in more detail while others such as the optimal dose of radiation in stage II disease, and the management of residual masses post-chemotherapy are discussed in the consensus statement generated from the conference. It is important to consider these controversies in the context of the excellent outcome of current therapy. It is extremely unusual in the management of neoplastic disease to be attempting to refine therapy when the expected cure rate is 97% as it is in seminoma. It is only when our understanding of the disease process is so good, and our treatments so effective, that we can afford to direct investigative effort to minimizing the morbidity of our therapies.
本文提出了一系列睾丸精原细胞瘤治疗中的争议问题。其中一些问题已进行了更详细的讨论,而其他问题,如Ⅱ期疾病的最佳放疗剂量以及化疗后残留肿块的处理,则在会议产生的共识声明中进行了讨论。在当前治疗取得优异疗效的背景下考虑这些争议很重要。在肿瘤疾病的治疗中,当预期治愈率如精原细胞瘤那样高达97%时还试图优化治疗是极不寻常的。只有当我们对疾病过程的理解如此透彻,且我们的治疗如此有效时,我们才能够将研究精力用于尽量减少治疗的发病率。