睾丸精原细胞瘤术后加放射治疗的临床意义

Clinical Analysis of postoperative radiotherapy for 40 patients with testicular seminoma

目的 分析睾丸精原细胞瘤术后放射治疗的疗效和预后因素。方法 1985年 5月至 1995年 5月共收治 4 0例睾丸精原细胞瘤 ,绝大部分病人行患侧睾丸附睾切除加精索高位结扎术 ;所有的病人手术后都采用了60 Co放射治疗 ;少部分Ⅲ期病人加用化疗。结果 全部病例都随访 5a以上 ,5a生存率分别为 :Ⅰ期 92 .5 % (2 5 / 2 7)、Ⅱ期 6 2 .5 % (5 / 8)、Ⅲ期 4 0 % (2 / 5 )。结论 睾丸精原细胞瘤术后加放射治疗的疗效最为理想 ,放射治疗剂量在DT2 5～ 30GY是安全有效的 ,患者能够长期生存。对Ⅲ期患者 ,放疗前后结合全身化疗可提高生存率。

Objective The curative effect and prognostic factors of testicular seminoma treated by postoperative radiotherapy were analyzed. Methods From May 1985 to May 1995, most of patients with testicular seminoma were firstly treated orchiectomy and minority. All patients were treated with postoperative radiotherapy and a little part of them were treated with combined radiotherapy and chemotherapy. Results All patients were followed up more than for 5 years. The overall 5-year survival rates were: 92.5%(25/27) for stageⅠ, 62.5%(5/8)for stage Ⅱ, 40%(2/5)for stage Ⅲ. Conclusions The curative effect of testicular seminoma treated by postoperative radiotherapy was best of all. Patients received radiation dose of 25～30GY were safety and effective. Patients were capable of a good survival rate. To reduce rate of recur and metastasis, boost survival rate for stage Ⅲ, radiotherapy combined with chemotherapy is necessary.