TAILIEUCHUNG - Chapter 092. Testicular Cancer (Part 4)

Stages I and II Seminoma Inguinal orchiectomy followed by retroperitoneal radiation therapy cures ~98% of patients with stage I seminoma. The dose of radiation therapy (2500– 3000 cGy) is low and well tolerated, and the in-field recurrence rate is negligible. About 2% of patients relapse with supradiaphragmatic or systemic disease. Surveillance has been proposed as an option, and studies have shown that about 15% of patients relapse. The median time to relapse is 12–15 months, and late relapses (5 years) may be more frequent than with nonseminoma. The relapse is usually treated with chemotherapy. Surveillance for clinical stage I. | Chapter 092. Testicular Cancer Part 4 Stages I and II Seminoma Inguinal orchiectomy followed by retroperitoneal radiation therapy cures 98 of patients with stage I seminoma. The dose of radiation therapy 25003000 cGy is low and well tolerated and the in-field recurrence rate is negligible. About 2 of patients relapse with supradiaphragmatic or systemic disease. Surveillance has been proposed as an option and studies have shown that about 15 of patients relapse. The median time to relapse is 12-15 months and late relapses 5 years may be more frequent than with nonseminoma. The relapse is usually treated with chemotherapy. Surveillance for clinical stage I seminoma is not recommended. Nonbulky retroperitoneal disease stage IIA and IIB is also treated with radiation therapy. Prophylactic supradiaphragmatic fields are not used. Relapses in the anterior mediastinum are unusual. Approximately 90 of patients achieve relapse-free survival with retroperitoneal masses 5 cm in diameter. Because at least one-third of patients with bulkier disease relapse initial chemotherapy is preferred for stage IIC disease. Chemotherapy for Advanced GCT Regardless of histology patients with stage IIC and stage III GCT are treated with chemotherapy. Combination chemotherapy programs based on cisplatin at doses of 100 mg m2 plus etoposide at doses of 500 mg m2 per cycle cure 70-80 of such patients with or without bleomycin depending on risk stratification see below . A complete response the complete disappearance of all clinical evidence of tumor on physical examination and radiography plus normal serum levels of AFP and hCG for 1 month occurs after chemotherapy alone in 60 of patients and another 10-20 become disease-free with surgical resection of residual masses containing viable GCT. Lower doses of cisplatin result in inferior survival rates. The toxicity of four cycles of the cisplatin bleomycin etoposide BEP regimen is substantial. Nausea vomiting and hair loss occur in most patients .

• Y học thường thức
• Testicular Cancer
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• BMC Cancer
• Testicular cancer survivors
• Germ cell tumors
• Premature aging
• Molecular aging
• Patient education websites
• Germ cell tumor
• Testicular malignancy
• Testicular germ cell tumour
• Non seminoma
• Frequent cannabis
• Tumor inflitrating neutrophil
• Prognostic value
• Testicular germ cell tumors
• Overall survival
• Health belief model
• Fasa city
• Social support
• Testicular self examination
• Cancer survivors
• Metabolic syndrome
• Cardio metabolic risk factors
• Racial differences
• Highest incidence rates
• Asians and Pacific Islanders
• Testicular germ cell cancer
• Cisplatin sensitivity
• Germ neoplasia in situ
• Undergo malignant transformation
• Mild Leydig cell insufficiency
• Testosterone substitution
• Hormonal disturbance
• Physical activity
• Increased adult height
• Risk factor
• Androgenic alopecia
• Prostate cancer
• Testicular germ cell tumor
• Meta analysis
• Health related quality of life
• Psychometric validation
• Patient reported outcome
• Germ cell neoplasia in situ
• Fibrillin 1
• Testicular germ cell tumours
• Cancer pathogenesis
• Nodal and Activin signalling
• Expression of pluripotency factors
• Germ cell cancer
• Germ cells
• Anti tumoral
• Anti angiogenic multikinase inhibitor
• Primary testicular lymphoma
• Diffuse large B cell lymphoma
• Initial treatment
• Therapy outcome
• Systemic chemotherapy
• Pure seminoma
• Semi quantitative score
• Testicular impairment
• Antioxidant enzymes
• Reproductive hormones
• DNA damages