Ⅰ～ⅡA/B期睾丸精原细胞瘤诊治及放疗进展  

Diagnosis and Radiotherapy for Patients with Testicular Seminoma Stages Ⅰand ⅡA/B

作　　者：陈志霄[1] 张铁宁[1] 胡烨[1] 王春刚[1] 赵国旗[1] 

机构地区：[1]上海交通大学附属第一人民医院,上海200080

出　　处：《中国肿瘤》2014年第6期509-513,共5页China Cancer

摘　　要：睾丸精原细胞瘤是青壮年男性的好发肿瘤之一。过去放疗一直是Ⅰ期及ⅡA/B期精原细胞瘤的术后标准治疗;但近年来Ⅰ期患者术后,密切随访、放疗、化疗均为可接受方案。ⅡA期术后标准治疗是放疗,ⅡB期可放疗或化疗。对于放疗患者,Ⅰ期可行单纯腹主动脉旁照射,或腹主动脉旁+同侧髂淋巴结区照射,剂量20Gy/10次,2周。Ⅱ期行腹主动脉旁+同侧髂淋巴结区照射20Gy/10次,2周,结束后针对病灶缩野加量至30Gy/15次,3周至36Gy/18次,3.6周。Testieular seminoma constitutes an important group of malignancies in young men. Al- though radiotherapy had been the standard treatment of seminoma patients clinical stage Ⅰand Ⅱ A/B in the past years,there is growing recognition that adjuvant radiotherapy is associated with an increased risk of late toxicity. In stage Ⅰ disease, it is recommended that patients should be informed of all treatment options, including surveillance, radiotherapy, or chemotherapy. In stage Ⅱ A disease,radiotherapy should be considered standard treatment if there are no eontraindica- tions. Otherwise,chemotherapy is an option. In stage Ⅱ B disease,chemotherapy or radiotherapy is reasonable treatment approach. The stage Ⅰ patients who choose adjuvant chemotherapy may be considered for（1） para-aortic RT to 20 Gy in 10 fractions over 2 weeks ,or （2） classic dog-leg RT to 20 Gy in 10 fractions over 2 weeks. For stage Ⅱ A orⅡ B patients ,dog-leg radiotherapy to 20 Gy in 10 fractions over 2 weeks followed by a 10 Gy in 15 fractions over 3 weeks boost to the adenopathy or a 16 Gy in 18 fractions over 3 weeks boost has been the standard treatment.

关 键 词：睾丸精原细胞瘤 放射治疗 诊断 

分 类 号：R737.21[医药卫生—肿瘤]