放射治疗在睾丸生精细胞肿瘤（非纯精原细胞瘤）治疗中的作用。

The role of radiation therapy in the treatment of germinal cell tumors of the testis other than pure seminoma.

作者信息

Hussey D H, Luk K H, Johnson D E

出版信息

Radiology. 1977 Apr;123(1):175-80. doi: 10.1148/123.1.175.

DOI:10.1148/123.1.175

Abstract

Between March 1944 and September 1976, 279 patients with nonseminomatous testicular tumors were treated. The 3-year NED rates for patients with Stages I, IIA, and IIB were 78.2%, 46.7%, and 17.6%, respectively. However, the results were better for patients treated with preoperative radiotherapy and lymphadenectomy with or without postoperative radiotherapy (Stage IIA: 77.5%--14/18; Stage IIB: 12.9%--3/7). Postoperative radiotherapy is not necessary for patients with negative nodes at lymphadenectomy because the periaortic failure rate is low for this group. However, when positive nodes are found, the control is improved with radiotherapy. The minimum tumor dose required when tumor is found but resected is not known. When there is gross residual tumor, a dose of 4,500-5,500 rad is required to achieve any salvage. In this series, 42.2% of patients with positive nodes at lymphadenectomy (Stages I and II) developed extranodal metastases. This group might benefit from adjunctive chemotherapy.

摘要

1944年3月至1976年9月期间，对279例非精原细胞瘤性睾丸肿瘤患者进行了治疗。I期、IIA期和IIB期患者的3年无疾病证据生存率分别为78.2%、46.7%和17.6%。然而，对于接受术前放疗及淋巴结清扫术（无论有无术后放疗）的患者，结果更好（IIA期：77.5%——14/18；IIB期：12.9%——3/7）。对于淋巴结清扫术时淋巴结阴性的患者，术后放疗并非必要，因为该组腹主动脉旁失败率较低。然而，当发现淋巴结阳性时，放疗可改善控制情况。肿瘤被发现但已切除时所需的最小肿瘤剂量尚不清楚。当有大体残留肿瘤时，需要4500 - 5500拉德的剂量才能实现任何挽救。在该系列中，淋巴结清扫术时淋巴结阳性的患者（I期和II期）中有42.2%发生了结外转移。该组可能从辅助化疗中获益。