Dilhuydy J M, Lagarde P, Chauvergne J, Mongodin B, Dilhuydy M H, Coindre J M, Avril A, Richaud P, Pigneux J
Service de radiothérapie, Fondation Bergonié, Bordeaux, France.
Bull Cancer. 1990;77(3):213-24.
The authors present a series of 10 pure dysgerminoma of the ovary treated between 1976 and 1984; mean age = 19.5 years, range 15-46 years. All patients had initial surgery: 8 annexectomies for 5 stages Ia and 3 stages IIIc nodal disease, 1 hysterectomy with bilateral adnexectomy for a 46 year old stade Ib patient and 1 case of salvage surgery for a progressive disease after a single adnexectomy. Two patients had no adjuvant therapy after initial adnexectomy (stage Ia tumors less than 10 cm in diameter). Four patients received a prophylactic subdiaphragmatic radiation therapy (3 stages Ia tumors larger than 10 cm, 1 stage Ib disease). Three patients received an irradiation for a subdiaphragmatic bulky disease and a prophylactic supradiaphragmatic irradiation (stage IIIc nodal disease). Two patients received chemotherapy, one for recurrence, the other for progressive disease. The authors discuss the therapeutic indications of pure dysgerminoma of the ovary, especially the conservative management of young patients wishing to preserve an hormonal and obstetric future and the value of radiologic and serologic follow-up. Recent data in the literature underline the efficacy of new combinations of cytotoxic agents and their role as an adjuvant of surgery in early as well as in advanced stages.
作者报告了1976年至1984年间治疗的10例卵巢单纯无性细胞瘤；平均年龄19.5岁，范围15 - 46岁。所有患者均接受了初次手术：8例行附件切除术，其中5例为Ia期，3例为IIIc期淋巴结转移；1例46岁Ib期患者行子宫全切及双侧附件切除术；1例在单侧附件切除术后疾病进展行挽救性手术。2例患者在初次附件切除术后未接受辅助治疗（Ia期肿瘤直径小于10cm）。4例患者接受了膈下预防性放疗（3例Ia期肿瘤直径大于10cm，1例Ib期疾病）。3例患者因膈下大块病变接受放疗及膈上预防性放疗（IIIc期淋巴结转移）。2例患者接受化疗，1例用于复发，另1例用于疾病进展。作者讨论了卵巢单纯无性细胞瘤的治疗指征，尤其是对于希望保留内分泌及生育功能的年轻患者的保守治疗，以及影像学和血清学随访的价值。文献中的最新数据强调了细胞毒性药物新联合方案的疗效及其在早期和晚期作为手术辅助治疗的作用。
