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Ⅰ期睾丸精原细胞瘤的传统疗法是睾丸切除术加膈下淋巴结照射。然而,根治性淋巴结清扫的资料表明,有淋巴结转移的时期患者不足10％,如果真是这样,则大多数患者无需放疗。尽管现代放疗剂量小,并发症少,但仍有发生消化道溃疡和非睾丸恶性肿瘤的可能。作者对52例临床Ⅰ期的精原细胞瘤患者切除睾丸后,未予淋巴结照射,而行临床监测,方案如下:术后2年中每2个月复查1次,包括胸片、血清AFP和HCG,第3次改为每3个月复查1次。此外,第1年中每2个月行腹部X线检查1次,术后18个月和30个月时行腹部超声检查;术后每年行胸、腹部CT检查1次。
The traditional treatment for stage I testicular seminoma is orchiectomy and axillary lymph node irradiation. However, data from radical lymph node dissections indicate that patients with lymph node metastases have less than 10% of the time. If this is the case, most patients do not need radiotherapy. Although modern radiation therapy has a small dose and few complications, there is still the possibility of peptic ulcer and non-testicular malignancy. The author of 52 patients with clinical stage I of seminoma, after removal of the testicles, without lymph node irradiation, and clinical monitoring, the program is as follows: After 2 years of surgery review every 2 months, including chest radiographs, serum AFP and HCG, changed to 3 times every 3 months. In addition, abdominal x-ray examination was performed every 2 months in the first year, abdominal ultrasound examination was performed at 18 months and 30 months after operation, and chest and abdomen CT examinations were performed once a year.