124例Ⅱ期非精原细胞瘤治疗分析

A review of 124 cases of atage Ⅱ non-spermatocytoma

目的 比较Ⅱ期非精原细胞瘤不同治疗方法的疗效。 方法 将 12 4例Ⅱ期非精原细胞瘤患者按治疗方法不同分三组 ,其中单纯手术组 (A组 ) 4 5例 ,手术 +术后放疗组 (B组 ) 4 0例 ,手术 +术后化疗组 (C组 ) 39例。比较三组局部复发率 ,远处转移率 ,3、5年生存率。 结果 A组局部复发率为 37.8% ,远处转移率为 42 .2 % ,3、5年生存率分别为 5 7.8%、40 .0 % ;B组局部复发率、远处转移率 ,3、5年生存率分别与A组相近 ,P均 >0 .0 5 ;C组局部复发率与A、B组相近 (P >0 .0 5 ) ,但远处转移率低于A、B组 ,且 3、5年生存率分别高于A、B组 ,P均 <0 .0 5。 结论 本组Ⅱ期非精原细胞瘤 (畸胎瘤、胚胎癌 )经放疗不能改变预后 ,且该类肿瘤易出现血行播散 ,术后放疗往往会延误化疗的最佳时机。该类肿瘤对化疗敏感 ,不仅可以杀灭手术时业己形成的亚临床灶 ,而且可杀灭因手术造成的医源性播散 ,可望降低局部复发应率、远处转移率、延长生存期。

Objective To evaluate the treatment of stage II non-spermatocytoma. Methods 45 cases were treated by open operation alone,40 cases by operation and postoperativeradiotherapy and 39 ca- ses by chemotherapy and operation.The therapeutic results of these 3 groups were compared. Results In patients with open operation alone ,the recurrence rate was 37.8%,the distance metastasis rate 42.2%,the 3 year survival rate 57.8% and the 5 year survival rate 40.0%.These were similar in patients with operation and radiotherapy( P >0.05).In patients with operation and chemotherapy,the distand metastasis rate has been lower and the 3、5 year survival rates higher( P <0.05). Conclusions Radiotherapy is non-effective for stage Ⅱ or higher stage non-spermatocytoma whereas chemotherapy would reduce the metastasis rate and prolong the survival time.