Ong Wee Loon, Nazareth Lester, Hindson Benjamin, Matheson Bronwyn, Millar Jeremy L
Alfred Health Radiation Oncology Service Prahran Victoria Australia; Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia.
Alfred Health Radiation Oncology Service Prahran Victoria Australia.
J Med Radiat Sci. 2016 Sep;63(3):161-9. doi: 10.1002/jmrs.170. Epub 2016 Apr 5.
The aim of the study is to review the long-term oncological outcomes and adverse effects of post-operative radiotherapy (PORT) for Stage I/II seminoma patients in an Australian radiation treatment centre.
This is a retrospective study of 125 patients with Stage I/II seminoma treated with PORT at the Alfred Health Radiation Oncology Service between 1992 and 2013. Patients were linked to the Victorian Cancer Registry to enable confirmation of survival and diagnosis of secondary malignancies (SM). The relapse-free survival (RFS), testicular-cancer-specific survival (TCSS), overall survival (OS) and SM-free survival (SMFS) were estimated with Kaplan-Meier methods.
The median age at diagnosis was 36 (range 20-62). The median time between diagnosis and PORT was 1.6 months (range: 0.5-4.5). Fifty patients (40%) had PORT to the para-aortic (PA) target alone, while the remaining had PORT to PA and ipsilateral or bilateral iliac lymph nodes. There were no acute adverse effects requiring admission. The median follow-up after PORT was 7.8 years (range = 0.1-19.1). There were two relapses, both of which occurred within 1 year of PORT (estimated 10-year RFS = 98.4%). Five deaths were reported, none of which were testicular cancer-related death (estimated 10-year TCSS = 100%, 10-year OS = 97.3%). There were seven SM (one lower lip cancer, one upper shoulder melanoma, one mesothelioma, two prostate cancer, one acute myeloid leukaemia and one contralateral testicular seminoma) reported in six patients, with estimated 10-year SMFS of 92.9%.
Our series confirms excellent oncological outcomes among patients with Stage I/II seminoma treated with PORT, with uncommon occurrence of SM.
本研究旨在回顾澳大利亚一家放射治疗中心对Ⅰ/Ⅱ期精原细胞瘤患者进行术后放疗（PORT）的长期肿瘤学结局及不良反应。
这是一项对1992年至2013年间在阿尔弗雷德健康放射肿瘤服务中心接受PORT治疗的125例Ⅰ/Ⅱ期精原细胞瘤患者的回顾性研究。患者与维多利亚癌症登记处建立联系，以确认生存情况及继发性恶性肿瘤（SM）的诊断。采用Kaplan-Meier方法估计无复发生存率（RFS）、睾丸癌特异性生存率（TCSS）、总生存率（OS）和无SM生存率（SMFS）。
诊断时的中位年龄为36岁（范围20 - 62岁）。诊断与PORT之间的中位时间为1.6个月（范围：0.5 - 4.5个月）。50例患者（40%）仅对腹主动脉旁（PA）靶区进行PORT，其余患者对PA及同侧或双侧髂淋巴结进行PORT。无需要住院治疗的急性不良反应。PORT后的中位随访时间为7.8年（范围 = 0.1 - 19.1年）。有2例复发，均发生在PORT后1年内（估计10年RFS = 98.4%）。报告了5例死亡，均与睾丸癌无关（估计10年TCSS = 100%，10年OS = 97.3%）。6例患者报告了7例SM（1例下唇癌、1例上肩部黑色素瘤、1例间皮瘤、2例前列腺癌、1例急性髓细胞白血病和1例对侧睾丸精原细胞瘤），估计10年SMFS为92.9%。
我们的系列研究证实，接受PORT治疗的Ⅰ/Ⅱ期精原细胞瘤患者具有良好的肿瘤学结局，SM发生率较低。
