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目的：分析睾丸精原细胞瘤术后病人的预后与临床分期，放射剂量，手术与放疗间隔时间等之间的关系。方法：自１９７８年２月到１９９４年７月共收治睾丸精原细胞瘤术后患者９１例。全部有病理证实。照射方法采用６０Ｃｏ外照射，照射范围包括精索，髂内外及腹主动脉旁淋巴引流区，Ⅲ期加照纵隔及锁骨上区，ⅡＢ期采用全腹移动条形野。结果：３，５和１０年生存率分别为Ⅰ期９８．２％、９７．８％和８４．６％，Ⅱ期７４．０％、６３．６％和５０．０％，Ⅲ期６０．０％、６０．０％和２５．０％；放射剂量≤２４Ｇｙ６０．０％、６０．０％和５０．０％，２５～３０Ｇｙ８６．４％、８６．３％和７２．０％，３１～３５Ｇｙ８７．５％、８３．３％和６６．７％，＞３５Ｇｙ５５．０％、５０．０％和６６．７％。手术与放疗间隔时间＜３０ｄ９０．０％、８６．０％和８２．１％，＞３０ｄ５７．１％、５７．９％和４１．７％。以Ⅰ期生存率最高，Ⅲ期最差；２５～３０Ｇｙ生存率最高，＞３５Ｇｙ组最差；手术与放疗间隔时间＜３０ｄ组生存率高于＞３０ｄ者。结论：睾丸精原细胞瘤术后病人临床分期越早，生存率越高；最佳照射量在２５～３５Ｇｙ；手术与放射治疗间隔时间不宜＞３０ｄ。
OBJECTIVE: To analyze the relationship between prognosis and clinical stage of patients with testicular seminoma after surgery, radiation dose, interval between surgery and radiotherapy. Methods: From February 1978 to July 1994, a total of 91 patients with testicular seminoma were treated. All confirmed by pathology. Irradiation method using 60Co external irradiation, the scope of radiation, including spermatic cord, internal and external iliac artery and abdominal aortic lymph node drainage area, stage Ⅲ plus mediastinum and supraclavicular region, Ⅱ B period of the whole belly moving strip field. Results: The 3, 5 and 10 year survival rates were 98.2%, 97.8% and 84.6% in stage Ⅰ, 74.0%, 63.6% and 50.0% in stage Ⅱ, stage Ⅲ, 60 respectively. 0%, 60.0% and 25.0%, respectively; radiation dose ≤24Gy60.0%, 60.0% and50.0%, 25-30 Gy86.4%, 86.3% and72.0% 35Gy 87.5%, 83.3% and 66.7%,> 35Gy 55.0%, 50.0% and 66.7%. The interval of operation and radiotherapy was <30d90.0%, 86.0% and 82.1%,> 30d57.1%, 57.9% and 41.7% respectively. The highest survival rate of stage Ⅰ, Ⅲ the worst; 25 ~ 30Gy highest survival rate,> 35Gy group worst; operation and radiotherapy interval <30d group survival rate higher than> 30d. Conclusion: The sooner the clinical staging of testicular seminoma patients is, the higher the survival rate is. The best irradiation dose is 25-35 Gy. The interval between surgery and radiotherapy should not be> 30 days.