Muggia F M
Cancer Chemother Pharmacol. 1985;15(1):1-5. doi: 10.1007/BF00257284.
The treatment of testicular cancer has undergone considerable evolution since the introduction of cisplatin and the widespread recognition of its curative potential in all stages of disease. Chemotherapy developments that have taken place include substitution of etoposide for vinblastine in some primary combinations and high-dose cisplatin regimens for patients with otherwise poor prognosis. Definition of timed survival restaging and reassessment of the role of radiation has taken place. In early disease stages, dissection of retroperitoneal nodes combined with either a short course of adjuvant chemotherapy or careful monitoring followed by salvage chemotherapy has yielded impressive results (greater than 90% cures) in node positive patients. These results have encouraged trials including careful follow up for patients with negative retroperitoneal and other findings (markers, computerized tomography) on clinical staging alone. Evolution of these treatment strategies should take place within the context of prospectively designed studies. In this brief overview of developments, we point out how the legacy from the successful application of chemotherapy will form the basis for additional achievements which will include the introduction of second-generation drugs and optimization of combined modality strategies.
自从顺铂问世以及其在疾病各阶段的治愈潜力得到广泛认可以来，睾丸癌的治疗发生了重大演变。化疗方面的进展包括在一些初始联合方案中用依托泊苷替代长春碱，以及为预后较差的患者采用高剂量顺铂方案。对定时生存再分期进行了定义，并重新评估了放疗的作用。在疾病早期阶段，对腹膜后淋巴结进行清扫，联合短期辅助化疗或密切监测，随后进行挽救性化疗，在淋巴结阳性患者中取得了令人瞩目的结果（治愈率超过90%）。这些结果促使开展相关试验，包括仅根据临床分期对腹膜后及其他检查结果（标志物、计算机断层扫描）为阴性的患者进行密切随访。这些治疗策略的演变应在前瞻性设计的研究背景下进行。在对这些进展的简要概述中，我们指出化疗成功应用所带来的遗产将如何为包括第二代药物的引入和联合治疗策略的优化在内的更多成就奠定基础。
