原发性附睾腺癌一例并文献复习

摘要

目的：分析总结原发性附睾腺癌的姑息性治疗方案，为临床治疗提供参考依据。方法报道1例原发性附睾腺癌病例，并以关键词“原发性附睾腺癌”及“primary epididymal adenocarcino-ma”或“primary adenocarcinoma of the epididymis”对中国期刊全文数据库（CNKI）、万方数据知识服务平台及 Medline 数据库的中英文文献进行检索，收集并分析检索到的有详细姑息性治疗方案的原发性附睾腺癌病例资料。结果该例为58岁男性患者，被确诊为原发性附睾腺癌并接受附睾腺癌根治术联合化学治疗，其后肿瘤反复复发，曾接受淋巴结清扫术及多种不同化学治疗方案，其中多西他赛＋卡铂化及伊立替康＋洛铂方案治疗有效，自附睾腺癌根治术后患者共存活13年余。检索文献后共收集国内外37例原发性附睾腺癌患者的资料，其中有报道复发后姑息性治疗方案的共7例，单一姑息性治疗手段（如手术、放射治疗或化学治疗）的疗效欠佳，而姑息性联合治疗方案可在一定程度上延长患者的生存时间。结论原发性附睾腺癌患者复发后行姑息性联合治疗仍可能使患者获益。临床医师应全面评估患者的机体状况，平衡利弊，考虑是否积极行姑息性治疗。%Objective To analyze and summarize the palliative treatment of primary adenocarcinoma of epididymis and provide evidence for clinical therapy.Methods In this article,we reported one case of pri-mary adenocarcinoma of epididymis.A comprehensive literature search was performed in China national knowl-edge infrastructure (CNKI),Wanfang and Medline databases using the keywords of “primary adenocarcinoma of epididymis”in Chinese and “primary epididymal adenocarcinoma”or “primary adenocarcinoma of the epi-didymis”.Both English and Chinese language studies were eligible.Clinical data of patients diagnosed with primary adenocarcinoma of epididymis who received palliative treatment were collected and analyzed.Results The male patient aged 58 years was diagnosed with primary adenocarcinoma of epididymis and underwent radi-cal surgery combined with chemotherapy.Subsequently,he experienced repeated recurrence.The patient un-derwent lymph node dissection and multiple chemotherapy regimes.Among them,docetaxel plus carboplatin, and irinotecan plus lobaplatin chemotherapies yielded clinical efficacy.He survived for over 1 3 years following radical surgery for the primary adenocarcinoma of epididymis.Clinical data were obtained from a total of 37 ca-ses of primary adenocarcinoma of epididymis.Seven patients received palliative therapy after recurrence.Single palliative treatment (such as surgery,radiotherapy or chemotherapy alone)yielded low clinical efficacy, whereas combined palliative therapies could prolong the patients’survival to certain extent.Conclusions Pa-tients with primary adenocarcinoma of epididymis can obtain clinical benefits from combined palliative therapies after recurrence.Physicians should comprehensively evaluate the patients’physical conditions and consider the advantages and disadvantages to determine whether the patients can undergo palliative treatment.