Zietman A L, Coen J J, Ferry J A, Scully R E, Kaufman D S, McGovern F G
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
J Urol. 1996 Mar;155(3):943-6.
The initial management of stage I nonHodgkin's lymphoma of the testis is by orchiectomy but the role and efficacy of adjuvant strategies are uncertain. We reviewed cases of lymphoma at our institution to determine whether adjuvant treatment was beneficial.
A retrospective review of outcome was conducted on 26 patients who presented to our institution. Median followup for the group was 54 months. Kaplan-Meier actuarial analyses were performed on the entire group and subsets. RESULTS; Actuarial 5 and 10-year overall survival rates were 79% and 63% and relapse-free survival rates were 61% and 46%, respectively. In patients who received adjuvant combination chemotherapy the 5-year relapse-free survival rate improved (75% versus 50%) but effect did not achieve statistical significance and was lost by 10 years. No relapse-free survival advantage was noted for patients receiving adjuvant irradiation to the pelvic and para-aortic nodes. Patients who did not receive irradiation remained free of isolated relapses in the pelvic or para-aortic regions.
These data lend support to the use of adjuvant chemotherapy but do not support a role for adjuvant nodal irradiation.
睾丸I期非霍奇金淋巴瘤的初始治疗是睾丸切除术，但辅助治疗策略的作用和疗效尚不确定。我们回顾了本机构的淋巴瘤病例，以确定辅助治疗是否有益。
对本机构收治的26例患者的治疗结果进行回顾性分析。该组患者的中位随访时间为54个月。对整个组和亚组进行了Kaplan-Meier生存分析。结果：5年和10年的总生存率分别为79%和63%，无复发生存率分别为61%和46%。接受辅助联合化疗的患者5年无复发生存率有所提高（75%对50%），但效果未达到统计学显著性，且到10年时这种差异消失。接受盆腔和主动脉旁淋巴结辅助放疗的患者未观察到无复发生存优势。未接受放疗的患者在盆腔或主动脉旁区域未出现孤立性复发。
这些数据支持使用辅助化疗，但不支持辅助性淋巴结放疗的作用。
