CAJ | 학술논문

背景与目的:临床Ⅰ期睾丸精原细胞瘤占精原细胞瘤的70%～80%,最近几十年治疗方案已发生了很大的变化.本文旨在分析Ⅰ期睾丸精原细胞瘤不同治疗方法与预后的关系.方法:回顾分析自1999年至2008年近十年间在中山大学肿瘤防治中心治疗的所有临床Ⅰ期精原细胞瘤患者的临床资料.根据睾丸癌根治术后治疗方式不同分为3组,化疗组30例,放疗组8例,观察组20例.Kaplan-Meier法计算5年总生存率和无疾病生存率,并比较三种治疗方法与肿瘤预后的关系.结果:临床Ⅰ期精原细胞瘤共58例,其中Ⅰ例失访,57例患者获得随访,中位随访时间为50个月(8～115个月).化疗组患者均生存,无肿瘤复发;放疗组随访无死亡,有1例复发;观察组患者均生存,有4例出现腹膜后转移.统计分析显示化疗组疗效优于观察组(P=0.005),而放疗组与观察组差异无统计学意义(P=0.364).结论:全身化疗是Ⅰ期精原细胞瘤根治性睾丸切除术后安全有效的治疗方案.
배경여목적:림상Ⅰ기고환정원세포류점정원세포류적70%～80%,최근궤십년치료방안이발생료흔대적변화.본문지재분석Ⅰ기고환정원세포류불동치료방법여예후적관계.방법:회고분석자1999년지2008년근십년간재중산대학종류방치중심치료적소유림상Ⅰ기정원세포류환자적림상자료.근거고환암근치술후치료방식불동분위3조,화료조30례,방료조8례,관찰조20례.Kaplan-Meier법계산5년총생존솔화무질병생존솔,병비교삼충치료방법여종류예후적관계.결과:림상Ⅰ기정원세포류공58례,기중Ⅰ례실방,57례환자획득수방,중위수방시간위50개월(8～115개월).화료조환자균생존,무종류복발;방료조수방무사망,유1례복발;관찰조환자균생존,유4례출현복막후전이.통계분석현시화료조료효우우관찰조(P=0.005),이방료조여관찰조차이무통계학의의(P=0.364).결론:전신화료시Ⅰ기정원세포류근치성고환절제술후안전유효적치료방안.
Background and Objective:Patients with clinical Stage-Ⅰ seminoma represent 70%-80% of patients with this disease.This study was to evaluate the prognosis of patients with different treatment.Methods:The data of all patients with clinical Stage-Ⅰ seminoma underwent multi-disciplinary approach in Sun Yat-sen University Cancer Center between 1999 and 2008 were retrospectively analyzed.The patients were subdivided into 3 groups according to their different treatment after orchiectomy:chemotherapy (n=30),radiotherapy (n=8),and surveillance (n=20).The prognosis of different groups was evaluated.Results:Among the 58 patients with Stage-Ⅰ seminoma,one failed to follow up and 57 were followed up successfully.Median follow-up time was 50 months (range,8-115 months).All 30 patients in the chemotherapy group were surviving without relapse or metastasis.One patient in the radiotherapy group developed relapse.Four patients in surveillance group got metastasis of retroperitoneal lymph node.The disease-free survival was significantly higher in the chemotherapy group than in the surveillance group (P=0.005).The relapse-free survival was not significantly different between the surveillance group and the radiotherapy group (P=0.364).Conclusion:Chemotherapy is a safe and effective treatment for patients with Stage-Ⅰ seminoma after radical orchidectomy.