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IN 1962 we gave an account of the treatment of patients with testicular tumours at the Royal Marsden Hospital and commented on two great steps forward in therapeutics that had been taken for this disease (Smithers and Wallace, 1962). These advances followed first, the regular use of irradiation after orchidectomy in the 1930's, and second, the use of supervoltage apparatus for this irradiation in the 1950's. A further step forward, this time in the accuracy of application of the radiation, has occurred in the 1960's through the regular use of lymphography for assessment and location of spread, the introduction of simulators for treatment planning, and the employment of linear accelerators for the radiotherapy.Today the cure of patients with pure seminomas of the testicle is usually achieved, and death from this cause is unexpected. The occasional fatality results only when a seminoma has already disseminated too widely before treatment is given. The present highly favourable results of treatment for patients with seminomas are partly due to better treatment but also to a better separation of the pure from the combined tumours where the seminoma and the teratoma usually occur in the same testicle and for which the prognosis depends on the nature of the teratoma present rather than on the seminoma. The results of treatment of patients with teratomas of the testicle are less satisfactory though the figure for the better-differentiated tumours now compares with that obtained for the seminomas some 20 years ago. There is still controversy over the classification of the poorly-differentiated tumours, generally regarded as anaplastic teratomas in this country and as carcinomas of embryonal type in America. While doubting if this difference in terminology represents any real divergence of opinion, we find interest in the American approach, since it is under these designations that the testicular tumours are to be found which display a tendency to maturation or which may respond dramatically to chemotherapy, behaving in much the same way as some of the embryonal tumours of children. It seems, indeed, that the prognosis may now be slightly better with the anaplastic teratomas than with the intermediate B teratomas. Only the trophoblastic tumours (unlike those of similar type in women) have so far been merely temporarily affected by treatment. In a pure form in men they were, in our experience, universally fatal, but lately there have been some more hopeful responses in recentlytreated patients who are still alive and in remission. Where some trophoblastic elements are to be found associated with a teratoma, the outlook is still grave but not quite so hopeless. We have included our few cases of this kind under the heading of the teratomas which formed the main tumour mass, so as to keep the true trophoblastic tumours separate.Few changes have been made in the post-operative radiation treatment technique since our last publication, but better treatment planning has been possible with the simulator, and the use of the 6 MeV l...