Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada,
Curr Urol Rep. 2013 Oct;14(5):525-33. doi: 10.1007/s11934-013-0365-2.
Seminoma represents about 60 % of all testicular germ cell tumors. At presentation about 80 % of patients have stage I and about 15 % have stage II disease. The last three decades have seen a substantial change in the philosophy of management with the success of surveillance as a strategy to minimize unnecessary treatment, recognition of the late effects of radiation therapy, and the success of cisplatin-based chemotherapy as curative treatment either in the first-line or salvage setting. Overall, in stage I disease where 80-85 % are cured with orchiectomy alone, efforts now are directed at reducing the burden of the disease and its diagnosis on patients with increasing utilization of surveillance and decreased employment of adjuvant therapy. For stage II disease, balancing the relative toxicities of radiation and chemotherapy while avoiding the use of multimodality therapy due to the additive long-term toxicity has become the priority.
精原细胞瘤约占所有睾丸生殖细胞肿瘤的 60%。就诊时，约 80%的患者为 I 期，约 15%的患者为 II 期疾病。在过去的三十年中，随着监测作为一种策略的成功，管理理念发生了重大变化，该策略可以最大限度地减少不必要的治疗，认识到放射治疗的后期影响，以及顺铂为基础的化疗作为一线或挽救治疗的成功，从而治愈疾病。总的来说，在 I 期疾病中，80-85%的患者仅通过睾丸切除术即可治愈，目前的努力方向是减少疾病及其诊断对患者的负担，增加监测的应用，减少辅助治疗的应用。对于 II 期疾病，平衡放射治疗和化学治疗的相对毒性，同时避免由于长期毒性的累加而使用多模式治疗，已成为当务之急。
