進行した精上皮腫に対する化学療法

概要

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進行した精上皮腫に対する放射線療法には限界があること,それゆえこのような症例では化学療法を第一選択とする集学的治療が必要である.1) bulky lymph node metastasisを有する症例およびstage 3の症例では,CDDPを含む化学療法を最初におこなうべきである.2)残存した腫瘍に対しては,放射線療法および外科療法を組み合せて施行することにより,従来不良であったこれらの症例の予後の改善が期待できるSeminoma is one of the most radiosensitive of the solid tumors. Radiotherapy provides a high cure rate for patients with stage I and II seminoma, but the survival rate of the patients with clinically advanced stage III seminoma is only about 30% in the literature. Our case of advanced metastatic seminoma was treated with cisplatinum, vinblastine and bleomycin. Metastatic tumors in the lung disappeared after chemotherapy but recurred shortly. Then regional radiation was given and the tumors disappeared completely. Subsequent prophylactic chemotherapy was given. In view of the observed chemosensitivity of seminoma, it appears that all patients who present initially with metastatic or bulky retroperitoneal disease should be treated with multiple drug chemotherapy including cis-platinum. Residual tumors can be treated by radiation and surgical resection, which will improve the cure rate of advanced metastatic seminoma.