Pilot studies of 2 and 1 course carboplatin as adjuvant for stage I seminoma: Should it be tested in a randomized trial against radiotherapy?

Oliver, R.T.D.; Edmonds, Polly; Ong, J.; Ostrowski, Marek; Jackson, Alun C; Baille-Johnson, H.; Williams, Michael; Wiltshire, Chris; Mott, T. J.; Pratt, William R.; Trask, C; Hope-Stone, H. F.

doi:10.1016/0360-3016(94)90219-4

Cited by 125 publications

(53 citation statements)

References 20 publications

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“…In order to avoid these side effects, a policy of 'watch and wait' has been evaluated at some centres (Maase et al, 1993;Warde et al, 1997) applying treatment only to those patients suffering from relapse. Other study groups have investigated the role of single-agent carboplatin as adjuvant treatment (Oliver et al, 1994;Dieckmann et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Para-aortic irradiation for stage I testicular seminoma: results of a prospective study in 675 patients. A trial of the German testicular cancer study group (GTCSG)

et al. 2004

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A prospective nonrandomised trial was performed in order to evaluate tumour control and toxicity of low-dose adjuvant radiotherapy in stage I seminoma with treatment portals confined to the para-aortic lymph nodes. Between April 1991 and March 1994, 721 patients were enrolled for the trial by 48 centres in Germany. Patients with pure seminoma and no evidence of lymph node involvement or distant metastases received 26 Gy prophylactic limited para-aortic radiotherapy. Disease-free survival at 5 years was the primary end point. With a median follow-up of 61 months, 675 patients with follow-up investigations were evaluable for this analysis. Kaplan -Meier estimates of disease-free and disease-specific survival were 95.8% (95% CI: 94.2 -97.4) and 99.6% (95% CI: 99.2 -100%) at 5 years and 94.9% (95% CI: 92.5 -97.4%) and 99.6% (95% CI: 99.2 -100%) at 8 years, respectively. A total of 26 patients relapsed. All except two were salvaged from relapse. In all, 21 recurrences were located in infradiaphragmatic lymph nodes without any 'in-field' relapse. Nausea and diarrhoea grade 3 were observed in 4.0 and 1.0% of the patients, respectively. Grade 3 late effects have not been observed so far. The results of our trial lend further support to the concept of limited para-aortic irradiation as the recently defined new standard of radiotherapy in stage I seminoma. There is no obvious compromise in disease-specific or disease-free survival compared to more extensive hockey-stick portals, which were used as standard portals at the time this study was initiated.

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Section: Discussionmentioning

confidence: 99%

Para-aortic irradiation for stage I testicular seminoma: results of a prospective study in 675 patients. A trial of the German testicular cancer study group (GTCSG)

et al. 2004

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“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Three were randomized controlled trials, 9 were phase 2 trials, and 5 were from prospective institutional databases. For purposes of summary data generation, these studies included a total of 5561 patients ( Table 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In 1 study, actuarial data were available from an older publication with only summary data available in a later abstract. 9,10 The more mature information is included for summary figures in Table 2, and actuarial data were used for the remainder of the analysis. One study arm from a randomized trial was not included in the analysis because it did not explicitly define the modality used for all patients who recurred, stating only ''radiotherapy'' when both extended-field radiotherapy and para-aortic radiotherapy were used.…”

Section: Study Characteristicsmentioning

confidence: 99%

Evidence‐based guidelines for following stage 1 seminoma

Martin

Panzarella

Zwahlen

et al. 2007

Cancer

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A chemically crosslinked biodegradable hydrogel was prepared via a macromer technique, and physicochemical characterizations associated with its potential application as an injectable biomaterial were carried out. The macromers were composed of poly(ethylene glycol) extended with oligomers of biodegradable polyesters such as oligolactide and end‐capped with acryloyl groups. Hydrogels were obtained through the polymerization of the macromer aqueous solutions in phosphate‐buffered saline initiated by a redox initiator system at body temperature. The initiator system was composed of ammonium persulfate as an initiator and N,N,N′,N′‐tetramethylethylene diamine as an accelerator. The modulus of this chemical gel was much higher than that of a Pluronic physical gel. In vitro biodegradation was also confirmed. The degradation rates were highly tunable by the adjustment of several factors, such as the kind of ester group, the block length of the oligoester, and even the concentration of the accelerator used in the crosslinking reaction. The gelation time could be adjusted to meet the requirements of an injectable biomaterial. The effect of the polymerization heat seemed not to be significant. This kind of biodegradable hydrogel might be in situ formed after being injected into the body and shows potential applications as a unique tissue engineering material free of porogening techniques in scaffold fabrication and less invasive in implantation. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci, 2006

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“…Regarding the uncertainty of lymph drainage after corrective surgery in SCIC, adjuvant chemotherapy may be an effective alternative in these patients (8,28).…”

Section: Prognosis and Treatmentmentioning

confidence: 99%

Seminoma arising in corrected and uncorrected inguinal cryptorchidism: Treatment and prognosis in 66 patients

Coucke

Qian

et al. 1997

International Journal of Radiation Oncology*Biology*Physics

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Purpose: The purpose of this study was to analyze prognosis and treatment results for seminoma arising in corrected and uncorrected inguinal cryptorchidism (SCIC and SUIC). Methods and Materials: We reviewed 66 patients with inguinal seminomas between June 1958 and December 1991 at the Cancer Hospital and Institute of Chinese Academy of Medical Sciences. Of these patients, 23 had prior orchiopexy and 43 presented with an inguinal form of cryptorchidism. At presentation, 17 of 66 (26%) patients had nodal metastases. This nodal involvement was 30% (7 of 23) for SCIC and 23% (10 of 43) for SUIC, respectively. These numbers are comparable with those in a series of patients treated for scrotal seminoma at our institution (26% vs. 20%). However, 3 of 23 (13%) patients who had prior orchiopexy presented with inguinal nodal metastasis as compared with 0 of 43 patients with SUIC or 4 of 237 patients with scrotal seminoma (p < .05). There were 49 stage I, 5 stage IIA, 8 stage IIB, 3 stage III, and 1 stage IV patients. All patients underwent radical orchiectomy and received further radiotherapy, chemotherapy, or both. Patients with stage I and stage II disease were treated primarily with radiotherapy, whereas patients with stage III and IV disease were treated with chemotherapy. Results: The overall and disease-free survival at 5 and 10 years was 94% and 92%, 89% and 87%, respectively. The overall 5-and lo-year survival by stage was 100% and 100% for stage I, and 77% and 68% for stage II, respectively @ < .05). There was no significant difference in survival between SUIC and SCIC (93% vs. 96% at 5 years). Four patients developed relapse. Two of these four patients experienced relapse at the inguinal area, due to a marginal miss. Three of four patients with relapse were successfully salvaged, and one died of disease. Conclusion: Our results indicate that prognosis for inguinal seminoma is excellent and similar to that of scrotal seminoma. Postorchiectomy radiotherapy can be considered as the standard treatment for stage I and IIA inguinal seminoma. We recommend routinely including the para-aortic and ipsilateral pelvic nodes. 0 1997 Elsevier Science Inc. Seminoma, Cryptorchidism, Radiotherapy.

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Pilot studies of 2 and 1 course carboplatin as adjuvant for stage I seminoma: Should it be tested in a randomized trial against radiotherapy?

Cited by 125 publications

References 20 publications

Para-aortic irradiation for stage I testicular seminoma: results of a prospective study in 675 patients. A trial of the German testicular cancer study group (GTCSG)

Para-aortic irradiation for stage I testicular seminoma: results of a prospective study in 675 patients. A trial of the German testicular cancer study group (GTCSG)

Evidence‐based guidelines for following stage 1 seminoma

Seminoma arising in corrected and uncorrected inguinal cryptorchidism: Treatment and prognosis in 66 patients

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