睪丸純精原細胞瘤的治療結果

TREATMENT RESULT OF TESTICULAR PURE SEMINOMA

曾烱堯(Jeong Yau Tzeng) ； 詹建勝(J. S. Jan) ； 吳永平(Y. P. Wu) ； 簡哲民(J. M. Jame) ； 羅志剛(C. K. Law) ； 林聰敏(Tsungmin Lin) ； 陳光耀(Kuang. Y. Chen)

《中華放射線醫學雜誌》 14卷2期 (1989/06) Pp. 177-181

摘要

台北榮民總醫院癌病治療中心自1970年1月至1988年12月，共有31例睪丸精原細胞瘤接受治療。所有病人均接受睪丸切除術或剖腹探査術切除腹部隱睪，並經病理報告證實爲純精原細胞瘤。病患年齡自24歲至72歲，中値年齡43歲。源自右側睪丸者17例，左側者13例，兩側者1例。發生在隱睪症病人有11例（35%）。主要症狀爲陰囊或鼠蹊溝腫大硬塊，或腹部硬塊及腹痛.31例中，第I例中，第I期有18例（58%），第II期有10例（32%）。第III及IV期有3例。第I、II期病人均接受手術後放射治療，除了暫時性放射線反應外並無重大併發症發生，第I期之五年存活率（actuarial survival）爲94%，第II期爲90%。第III、IV期接受化學治療加上局部放射治療，存活期分別爲58，32，56個月，後二例仍無病生存。

關鍵字

純精原細胞瘤（pure seminoma） ； 放射治療（radiotherapy） ； 化學治療（chemotherapy）

並列摘要

Thirty one testicular seminoma patients who received treatment from January 1970 to December 1988 at the Veterans General Hospital, Taipei, were reviewed. All patients had histological diagnosis of pure seminoma after orchiectomy. The median age was 43. There were 17 patients with the tumor arising from right testis, 13 from the left and 1 patient had bilateral disease. Eleven seminoma cases developed in patients with cryporchidism (35%). The common symptoms or signs were mass of scrotum or inguinal and lower abdominal area, 5 had abdominal or back pain. All patients received postoperative radiotherapy, either alone (early stage) or in combination with chemotherapy (late state). The 5-year actuarial survival of the 18 stage I patients was 94%, 90% for the 10 state II patients. The 3 patients presenting with disseminated disease (stage III & IV) showed promising response after cisplatin-containing combination chemotherapy and local radiotherapy, the survival time was 58, 32, 56 months respectively, the last two cases are still living with no evidence of disease.