Thomas G M, Rider W D, Dembo A J, Cummings B J, Gospodarowicz M, Hawkins N V, Herman J G, Keen C W
Int J Radiat Oncol Biol Phys. 1982 Feb;8(2):165-74. doi: 10.1016/0360-3016(82)90509-0.
Four hundred and forty-four patients with the histological diagnosis of pure seminoma were treated at The Princess Margaret Hospital between 1958 and 1976. Using the Walter Reed Hospital staging classification, 338 patients (76.1%) were Stage I, 86 (19.4%) were Stage II, and 20 (4.7%) were Stage III. The 5 year actuarial survival rate (5 yr Sa) for all stages was 87%, and for Stages I, II and III: 94%, 74% and 32% respectively. In Stage II the 5-year Sa was significantly worse when palpable abdominal disease was present (62%, vs 87% when it was absent, p less than .02). Prophylactic mediastinal irradiation was not used for patients with Stage II disease. None of 40 Stage II patients without palpable abdominal disease recurred in the non-irradiated mediastinum. Ten of 46 Stage II patients with palpable abdominal disease recurred in the mediastinum; 7 of the 10 were cured with mediastinal irradiation at the time of relapse. Prophylactic mediastinal irradiation appears unnecessary in Stage II patients. The Stage III category includes a subgroup of patients who were curable with radiation therapy:L 5/6 with supradiaphragmatic nodal disease without palpable abdominal or visceral disease were cured. Exploration of new treatment methods appears indicated for the salvage of patients recurring in sites other than the mediastinum or supraclavicular fossa and for patients presenting with visceral disease.
1958年至1976年间，444例经组织学诊断为纯精原细胞瘤的患者在玛格丽特公主医院接受了治疗。采用沃尔特·里德医院分期分类法，338例患者（76.1%）为I期，86例（19.4%）为II期，20例（4.7%）为III期。所有分期的5年精算生存率（5 yr Sa）为87%，I期、II期和III期分别为94%、74%和32%。在II期，当可触及腹部病变时，5年生存率明显较差（62%，而无腹部病变时为87%，p<0.02）。II期疾病患者未采用预防性纵隔照射。40例无腹部可触及病变的II期患者中，无1例在未照射的纵隔复发。46例有腹部可触及病变的II期患者中有10例在纵隔复发；其中7例在复发时经纵隔照射治愈。II期患者似乎无需预防性纵隔照射。III期包括一组可通过放射治疗治愈的患者：L 5/6有膈上淋巴结病变且无腹部或内脏可触及病变的患者被治愈。对于在纵隔或锁骨上窝以外部位复发的患者以及有内脏疾病的患者，探索新的治疗方法似乎是必要的。
