The management of metastatic seminoma testis
The management of metastatic seminoma testis
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睾丸转移性精原细胞瘤的治疗
作者：
D. Ball;A. Barrett;M. Peckham
本文报告了85例未经治疗的转移性精原细胞瘤患者的临床资料。在II期疾病中，复发率与转移灶的大小有关。IIA（32例）复发率为9.4%；IIB（11例），18.2%；IIC 23例，占39.1%。IIC患者的持续无病生存率明显低于IIA和IIB患者（P = 0.023）。在13名II期疾病患者中，没有观察到膈上淋巴结首次复发的病例，放疗仅限于膈下淋巴结。在复发的IIC期患者中，淋巴外转移与腹部复发一样频繁。在这些观察的基础上，加上9名接受含顺铂化疗的男性患者的初步数据，这些患者均处于完全缓解期，建议IIA期和IIB期患者应接受放射下照射，化疗推迟到复发。IIC期患者应先接受化疗，然后再进行放疗。在III期和IV期疾病中，化疗应作为初始治疗，针对个体化基础上的大体积疾病进行放疗。血液中B - HCG水平的中度升高与单纯精原细胞瘤的诊断并不矛盾，似乎也不会对放射治疗的结果产生不利影响。
Clinical details of 85 men presenting with previously untreated metastatic seminoma are presented. In Stage II disease relapse rate was related to the size of metastases. In IIA (32 patients) the relapse rate was 9.4%; IIB (11 patients), 18.2%; and IIC (23 patients), 39.1%. The continuous disease‐free survival rate was significantly worse for IIC than IIA and IIB patients (P = 0.023). No instance of first relapse in supradiaphragmatic nodes was observed in 13 men with Stage II disease treated with irradiation limited to infradiaphragmatic nodes. In relapsing Stage IIC patients, extralymphatic metastasis was as frequent as abdominal relapse. On the basis of these observations, together with preliminary data in nine men receiving Cis‐platinum‐containing chemotherapy, all of whom are in complete remission, it is proposed that patients with Stage IIA and IIB disease should receive infradiaphragmatic irradiation with chemotherapy deferred until relapse. Stage IIC patients should receive chemotherapy initially, followed by irradiation. In Stage III and IV disease chemotherapy should be initial therapy with radiotherapy for bulky disease on an individualised basis. Moderate elevation of blood B‐HCG levels is not inconsistent with a diagnosis of pure seminoma and does not appear to influence adversely the outcome of radiotherapy.
播散性精原细胞瘤的化疗。
DOI：
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发表时间：
1980
期刊：
Cancer clinical trials
影响因子：
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作者：
Einhorn,LH;Williams,SD
通讯作者：
Williams,SD