Nakai Yasutomo, Nagahara Akira, Uemura Motohide, Takayama Hitoshi, Nonomura Norio
The Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
Hinyokika Kiyo. 2012 Dec;58(12):715-20.
Most stage I testicular germ cell tumors are curable by orchiectomy alone. However, some tumors recur and require subsequent treatment. The point for the management of stage I testicular germ cell tumors is how to reduce the recurrence rate by appropriate adjuvant treatment with less adverse events. The strategy for stage I seminoma and stage I nonseminoma is different. The adjuvant treatment options include radiotherapy and 1-2 courses of carboplatin for seminoma and retroperitoneal lymph node dissection (RPLND) and 1-2 courses of bleomycin, etoposide and cisplatin chemotherapy for nonseminoma. This review discusses recent literature on adjuvant treatment and updates the consensus for the management of stage I testicular germ cell tumor.
大多数Ⅰ期睾丸生殖细胞肿瘤仅通过睾丸切除术即可治愈。然而,一些肿瘤会复发,需要后续治疗。Ⅰ期睾丸生殖细胞肿瘤管理的关键在于如何通过适当的辅助治疗降低复发率,同时减少不良事件。Ⅰ期精原细胞瘤和Ⅰ期非精原细胞瘤的治疗策略不同。辅助治疗方案包括:精原细胞瘤采用放疗和1 - 2个疗程的卡铂;非精原细胞瘤采用腹膜后淋巴结清扫术(RPLND)以及1 - 2个疗程的博来霉素、依托泊苷和顺铂化疗。本综述讨论了关于辅助治疗的最新文献,并更新了Ⅰ期睾丸生殖细胞肿瘤管理的共识。