Radiotherapy for Stages IIA/B Testicular Seminoma: Final Report of a Prospective Multicenter Clinical Trial

Claßen, Johannes; Schmidberger, Heinz; Meisner, Christoph; Souchon, Rainer; Sautter-Bihl, Marie-Luise; Sauer, Rolf; Weinknecht, S.; Köhrmann, Kai-U.; Bamberg, M.

doi:10.1200/jco.2003.06.065

Cited by 219 publications

(105 citation statements)

References 21 publications

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“…We know that radiotherapy is highly effective in eradicating disease with up to 5 cm in size in the para-aortic nodes (Classen et al, 2003;Chung et al, 2004). Our current protocol for treating patients with stage IIa/b disease, is to give one cycle of carboplatin (AUC 7) followed 4 weeks later by para-aortic radiotherapy to a dose of 30 Gy in 15 fractions based on 5-year relapse-free survival probability of 96.9% (Patterson et al, 2001) achieved at our institution.…”

Section: Stages Iia/bmentioning

confidence: 99%

“…There is considerable variability on how stage IIa/b seminomas are treated. The treatment options for stage IIa/b seminomas include, para-aortic and iliac node radiotherapy (Schmidberger et al, 1997;Warde et al, 1998;Classen et al, 2003;Chung et al, 2004), three cycles of BEP (bleomycin, etoposide and cisplatin) or four cycles of EP (etoposide and cisplatin) chemotherapy or a combination of carboplatin chemotherapy and para-aortic radiotherapy (Warde et al, 1998;Arranz Arija et al, 2001;Patterson et al, 2001). All three of the above options provide high rates of cure, but with differing toxicity profiles.…”

Section: Stages Iia/bmentioning

confidence: 99%

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Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse

Gilbert

Money-Kyrle

et al. 2008

Br J Cancer

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Testicular germ cell tumours (TGCTs) are the most common cause of cancer in men between the ages of 15 and 40 years, and, overall, the majority of patients should expect to be cured. The European Germ Cell Cancer Consensus Group has provided clear guidelines for the primary treatment of both seminoma and nonseminomatous germ cell tumours. There is, however, no international consensus on how best to follow patients after their initial management. This must promptly and reliably identify relapses without causing further harm. The standardising of follow-up would result in optimising risk-benefit ratios for individual patients, while ensuring economic use of resources. We have identified the seven common scenarios in managing seminomas and nonseminomas of the various stages and discuss the pertinent issues around relapse and follow-up. We review the available literature and present our comprehensive TGCT follow-up guidelines. Our protocols provide a pragmatic, easily accessible user-friendly basis for other centres to use or to adapt to suit their needs. Furthermore, this should enable future trials to address specific issues around follow-up giving meaningful and useful results. BackgroundTesticular germ cell tumours (TGCTs) are uncommon malignancies but the most common cause of cancer in men between the ages of 15 and 40 years. The peak incidence for nonseminomatous germ cell tumour (NSGCT) is between 20 and 30 years of age, and for seminoma between 30 and 40 years. In the United Kingdom, the incidence rate is only 1 : 100 000 men per year with a lifetime risk of developing a TGCT of 1 in 400 and 1900 new cases per year (Horwich, 2002). There has, however, been a steady increase in the incidence of TGCTs in European countries in the last two decades (Bergstrom et al, 1996). The reasons for this increasing incidence and the aetiology of TGCTs remain unknown. The European Germ Cell Cancer Consensus Group has provided clear guidelines for the primary treatment of both seminoma tumour and NSGCT (Schmoll et al, 2004). There is, however, a lack of clear consensus on how to follow patients after primary treatment, and a number of issues dictate that follow-up should be carefully thought out and rigorously adhered to. Here, we discuss these factors as they pertain to male germ cell tumour (GCT) practice and describe our recently developed protocols. Rational for follow-upDetecting relapse In general, detecting relapse is the major reason for maintaining follow-up and is the main focus of this review. The management of testicular cancer has been a major oncological success story, and provides a model for the management of curative solid tumours (Horwich et al, 2006). The use of platinumbased chemotherapy schedules has resulted in high cure rates for all stages of the disease (International Germ Cell Cancer Collaborative Group, 1997). The fact that the majority of young men treated for testicular cancer have a durable response to primary treatment has resulted in the accumulation of significant data on both the patterns ...

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Section: Stages Iia/bmentioning

confidence: 99%

Section: Stages Iia/bmentioning

confidence: 99%

Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse

Gilbert

Money-Kyrle

et al. 2008

Br J Cancer

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“…1,10 Whole pelvis should be considered only if lymphatic disruptions occur such as following pelvic operation, inguinal hernia repair or surgery due to mal-or undescended testis. 4,12 Prophylactic mediastinal and left supra-clavicular irradiation has been totally omitted due to its non-contribution to survival and increased rate of secondary malignancies, such as lung and thyroid cancer, and of cardiovascular diseases. 3,5 Among the current radiotherapy strategies to improve the therapeutic ratio in early stage seminoma are computed tomography-based traditional radiotherapy, bone-marrowsparing intensity modulated radiotherapy (BMS-IMRT), reducing the dose to the small and large bowel, stomach, pancreas and liver, and proton therapy.…”

Section: Discussionmentioning

confidence: 99%

“…1A and B). 4 The whole pelvis ("inverted-Y" method) was irradiated in three patients due to scrotal violation and previous inguinal repair in the presence of an undescended testis. Since 1980, dosages have been in the range of 2250-2550 cGy, with a total dose median of 2500 cGy (daily fractions of 150-200 cGy).…”

Section: Methodsmentioning

confidence: 99%

Radiotherapy for Stage IIA seminoma: The Northern Israel Oncology Center Experience, 1971–2010

Stein

Zidan

Charas

et al. 2014

Reports of Practical Oncology & Radiotherapy

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“…10 Several chemotherapy regimens have proven to be effective, but the most commonly used is the combination of bleomycin, etoposide and cisplatin (BEP).…”

Section: Stage Iia/b Seminomamentioning

confidence: 99%

Diagnosis and management of testicular cancers

Rodríguez‐Vida

2013

Trends Urol & Men's Health

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Radiotherapy for Stages IIA/B Testicular Seminoma: Final Report of a Prospective Multicenter Clinical Trial

Abstract: Radiotherapy for stages IIA/B seminoma with reduced portals yields excellent tumor control at a low rate of acute toxicity and no late toxicity, which supports the role of radiotherapy as the first treatment choice for these patients.

Cited by 219 publications

References 21 publications

Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse

Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse

Radiotherapy for Stage IIA seminoma: The Northern Israel Oncology Center Experience, 1971–2010

Diagnosis and management of testicular cancers

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