Ⅰ期睾丸精原细胞瘤术后放射治疗的临床分析

Clinical Analysis of Postoperative Radiotherapy for Stage I Seminoma

目的 探讨Ⅰ期睾丸精原细胞瘤术后放疗的临床效果。方法 自 1993年至 1999年 ,对 3 0例Ⅰ期睾丸精原细胞瘤病人在睾丸切除术后 ,设“狗腿子野”对膈下、腹主动脉旁及同侧髂血管淋巴结引流区行预防照射 ,每次DT1 5～ 1 8Gy ,总DT2 5～ 3 0Gy。结果 随访 1年半～ 7年 ,平均 4年 2个月 ,仅 1例在放疗后 4年发生腹膜后淋巴结转移 ,经再次放疗及全身化疗后治愈 ,其余患者未见复发和转移。结论 Ⅰ期睾丸精原细胞瘤术后辅以“狗腿子野”放疗 ,治疗效果好 。

Objective To discuss the clinical efficacy of postoperative radiotherapy for stage Ⅰ seminoma.Methods From 1993 to 1999,30 stage Ⅰ seminoma patients with orchectomy underwent preventative radiotherapy with 'dog leg' field include the subphreinic,paraaortic and ipsilateral iliac blood vessel lymph node regions.the total dose was 25 to 30 Gy in 1.5 to 1.8 Gy pre fraction.Results The follow up time was 1.5 to 7 years with a mean time of 4 years and 2 months.Only one case had retroperitoneum metastasis after 4 years and was retreated with radiotherapy and chemotherapy.No recurrence and metastasis were observed in the other patients.Conclusions Patients with stage Ⅰ seminoma who were treated with mastectomy and postoperative radiotherapy can reach a long term survival.