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195 8年至 1 990年 1 2月 ,收治 2 0 0例Ⅰ期睾丸单纯精原细胞瘤。所有病人在睾丸切除术后行膈下放疗。全组 5、1 0和 2 0年生存率分别为 98 9%、98 2 %、和 96 8%。 7例治疗后复发 ,多数远处转移 ,腹腔复发和照射剂量低有关。远期并发症中 ,3%的患者合并十二指肠球部溃疡和胃粘膜脱垂 ,下肢水肿和放射性膀胱炎少见。 9%的病人发生第二原发肿瘤 ,其中 4 5 %发生在 1 0年后。无论是否经阴囊手术或肿瘤侵犯白膜 ,均不必行阴囊和腹股沟照射。我们认为 ,腹主动脉旁和同侧髂血管淋巴引流区预防照射仍然是安全有效的 ,并发症极少 ,照射剂量以DT2 5Gy为宜。
195 years from 8 years to 1 990 years in January, treated 200 cases of stage I testicular pure seminoma. All patients underwent subphrenic radiotherapy after orchiectomy. The 5-, 10-, and 20-year survival rates for the whole group were 98 9%, 98 2%, and 96 8%, respectively. Seven patients relapsed after treatment, most distant metastases, abdominal recurrence and low radiation dose. Among the long-term complications, 3% of patients had duodenal ulcers and gastric mucosal prolapse, and lower extremity edema and radiation cystitis were rare. The second primary tumor occurred in 9% of the patients, with 45% occurring after 10 years. Whether scrotal surgery or tumor invasion of the tunica albuginea, scrotal and groin irradiation is not necessary. We believe that the prevention of irradiation in the lymphatic drainage area of the paraaortic and ipsilateral iliac vessels is still safe and effective, with few complications, and the irradiation dose should be DT2 5Gy.