Langzeittumorkontrolle und Fertilität nach paraaortal limitierter Radiotherapie des Seminoms im Stadium I

Abstract

After exclusive paraaortic radiation of Stage I seminoma, even at follow-up periods in excess of 5 years the incidence of pelvic lymph node relapses remains below 4%. However, there seems to be a small potential for the development of late recurrences. With limited radiotherapy, permanent radiation-induced effects on the remaining testicle are very unlikely.

Autorenschaft wissenschaftlicher Veröffentlichungen Analyse der Zeitschrift “Strahlentherapie und Onkologie”

“…Im Median hatten die Arbeiten im untersuchten Zeitraum fünf Autoren, dies war bei 29 Publikationen der Fall [1,2,7,17,18,19,30,32,33,39,47,48,58,63,64,67,68,77,81,87,99,101,105,113,119,125,140,147,159]. Es gab 16 Beiträ-ge mit sechs [14,29,31,34,45,54,84,93,97,106,107,118,120,136,137,139], 14 mit sieben [27,44,51,55,76,82,…”

Aktuarische Auswertung von Zeit-Ereignis-Daten und ihre Bedeutung bei der Beurteilung von Resultaten Qualitätsanalyse der Zeitschrift “Strahlentherapie und Onkologie”

“…Der zeitliche Verlauf der Anzahl der Patienten im Risiko wurde in 22 dieser 45 Arbeiten (49%; 95%-Konfidenzintervall: 33 bis 65%) dokumentiert [15, 17, 19, 28, 30-32, 64, 69-71, 96, 108, 118, 131, 137, 139, 149, 156, 163, 169, 177]. In ebenfalls elf Arbeiten wurden die Ergebnisse lediglich nicht aktuarisch ("crude") ausgewertet [5,24,72,77,81,128,132,144,150,151,153]. In zwei Arbeiten [22,25] Table 2.…”

Changing Paradigms in the Adjuvant Treatment of Stage I Seminoma?

“…The compiled pelvic relapse rate of all publications is below 1%. In series with longer follow-up periods, there is a slight tendency to higher failure rates up to 3.5% without comprising overall survival [11,12].…”

“…With truncation of the inferior border at L4/5, testicular doses can be held below 30-40 cGy where no permanent radiation-induced effects on the patient's fertility have to be expected. At scatter doses below 20 cGy, probably even transient effects can be avoided [11,15]. However, since part of the pelvic relapses are situated in the common iliac vessel region, Thomas [3] has proposed the inclusion of these structures into the treatment volume.…”

“…This field modification would keep the gonadal scatter doses acceptably low. Whether additional lead shielding of the remaining testicle is to be performed or not, should depend on individual in vivo dosimetry [11,15].…”