Bauman G S, Venkatesan V M, Ago C T, Radwan J S, Dar A R, Winquist E W
Department of Radiation, London Regional Cancer Centre, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 1998 Sep 1;42(2):313-7. doi: 10.1016/s0360-3016(98)00227-2.
A retrospective review of patients with Stage I and II seminoma treated at a regional cancer center was performed to assess the long term efficacy and toxicity associated with post operative radiotherapy.
Between 1950 and 1995, 212 patients seen at the London Regional Cancer Centre received adjuvant radiotherapy following orchiectomy for Stage I (169) and II (43) seminoma. Median follow-up for the group was 7.5 years.
Progression free, cause specific, and overall survival were 95%, 98%, and 95% at 5 years, and 94%, 98%, and 94% at 10 years respectively. An increased risk of failure was noted among patients with bulky Stage II disease. No other prognostic factors for relapse were identified. Late toxicity was uncommon with only 12/212 (6%) developing any late GI toxicity potentially attributable to radiotherapy. The incidence of second malignancies (excluding second testicular tumors) was 6/212 (actuarial:1%, 1%, 6% at 5,10,15 years respectively). There was a trend toward increased acute complications for patients treated with larger volumes of radiation. No prognostic factors associated with increased risk of late toxicity or second malignancy were identified, likely a consequence of the small number of these events.
Survival and toxicity were comparable to that reported in the literature. Post-operative radiotherapy remains a safe and efficacious adjuvant treatment for Stage I and early Stage II seminoma.
对一家地区癌症中心治疗的I期和II期精原细胞瘤患者进行回顾性研究，以评估术后放疗的长期疗效和毒性。
1950年至1995年间，伦敦地区癌症中心的212例患者在睾丸切除术后接受了I期（169例）和II期（43例）精原细胞瘤的辅助放疗。该组患者的中位随访时间为7.5年。
5年时的无进展生存率、病因特异性生存率和总生存率分别为95%、98%和95%，10年时分别为94%、98%和94%。II期大块肿瘤患者的失败风险增加。未发现其他复发的预后因素。晚期毒性不常见，只有12/212（6%）出现任何可能归因于放疗的晚期胃肠道毒性。第二原发恶性肿瘤（不包括第二睾丸肿瘤）的发生率为6/212（5年、10年、15年的精算发生率分别为1%、1%、6%）。接受较大照射体积治疗的患者急性并发症有增加的趋势。未发现与晚期毒性或第二原发恶性肿瘤风险增加相关的预后因素，可能是由于这些事件数量较少。
生存率和毒性与文献报道相当。术后放疗仍然是I期和早期II期精原细胞瘤安全有效的辅助治疗方法。
