Steinfeld A, Newall J
Division of Radiation Oncology, New York University Medical Center, New York.
Urology. 1988 Mar;31(3):202-6. doi: 10.1016/0090-4295(88)90139-2.
The general success in treating seminoma (Stages I and II) of the testicle has prompted questions regarding the extent of treatment that these patients require. We reviewed 79 patients treated at NYU/Bellevue Medical Center from 1965 to 1984 to establish a data base from which the controversies surrounding this disease can be viewed. Standard treatment involved a radical inguinal orchiectomy as primary therapy. Stage I patients received adjuvant radiation to para-aortic and ipsilateral iliac nodes, with additional radiation given routinely to the mediastinum of patients with Stage II disease. No major complications were observed. All Stage I patients remain free of recurrent tumor with a median follow-up of eight years. There were 4 deaths from seminoma among the Stage II patients. The use of prophylactic mediastinal radiation for Stage II patients, and observation only for Stage I patients are reviewed in light of our results and other published series. While early evidence suggests that both approaches may be reasonable, their adoption awaits confirmation by prospective trial.
睾丸精原细胞瘤（I期和II期）治疗的总体成功引发了关于这些患者所需治疗程度的问题。我们回顾了1965年至1984年在纽约大学/贝莱维医疗中心接受治疗的79例患者，以建立一个数据库，从中可以审视围绕该疾病的争议。标准治疗包括根治性腹股沟睾丸切除术作为主要治疗方法。I期患者接受辅助放疗至腹主动脉旁和同侧髂淋巴结，II期疾病患者的纵隔常规给予额外放疗。未观察到重大并发症。所有I期患者在中位随访8年时均无肿瘤复发。II期患者中有4例死于精原细胞瘤。根据我们的结果和其他已发表的系列研究，对II期患者使用预防性纵隔放疗以及仅对I期患者进行观察进行了综述。虽然早期证据表明这两种方法可能都是合理的，但它们的采用有待前瞻性试验的证实。
