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睾丸肿瘤是一种较少见的男性实体恶性肿瘤。化疗和放疗是有效的治疗手段。对于Ⅰ期精原细胞瘤,进行后腹膜淋巴结预防性照射。肿瘤量给予25～30Gy/3～4周,其三年无病生存率和总生存率各为95％和99％。对Ⅱ_a和Ⅱ_b期,进行主动脉旁放疗。纵隔区和锁骨上区不作常规照射。对Ⅱc期患者,选择性采用后腹膜放疗和化疗。对巨大肿瘤给予20Gy以上的全腹腔照射,并避开脊髓。Ⅲ期患者的治疗是以顺铂为基础的化疗为主,化疗+放疗比单纯化疗无明显优越性。Ⅳ期患者也是用顺铂为基础的化疗,对于残留肿瘤,采用局部补充放疗。
Testicular cancer is a rare male solid malignant tumor. Chemotherapy and radiotherapy are effective treatments. For stage I seminomas, prophylactic retroperitoneal lymph nodes were performed. Tumor volume was given 25 to 30 Gy/3 to 4 weeks. The 3-year disease-free survival rate and overall survival rate were 95% and 99% respectively. Phase II_a and II_b phases are performed with aortic radiotherapy. The mediastinal and supraclavicular regions are not routinely illuminated. For stage IIc patients, retroperitoneal radiotherapy and chemotherapy are selectively used. Give a large tumor with a total dose of 20 Gy or more and avoid the spinal cord. The treatment of stage III patients is based on cisplatin-based chemotherapy, and chemotherapy + radiotherapy is not superior to chemotherapy alone. Patients with stage IV are also treated with cisplatin-based chemotherapy, and local residual radiotherapy is used for residual tumors.