Yonsei Med J.  2015 Jan;56(1):24-30. 10.3349/ymj.2015.56.1.24.

Adjuvant Radiotherapy Outcome of Stage I Testicular Seminoma: A Single Institution Study

• Lee H
• Kim JW
• Hong SJ
• Yang SC
• Choi YD
• Rha KH
• Cho J

• KMID: 2352785
• DOI: http://doi.org/10.3349/ymj.2015.56.1.24

Abstract

PURPOSE
To analyze treatment outcome and side effects of adjuvant radiotherapy using radiotherapy fields and doses which have evolved over the last two decades in a single institution.
MATERIALS AND METHODS
Forty-one patients received radiotherapy after orchiectomy from 1996 to 2007. At our institution, the treatment field for stage I seminoma has changed from dog-leg (DL) field prior to 2003 to paraaortic (PA) field after 2003. Fifteen patients were treated with the classic fractionation scheme of 25.5 Gy at 1.5 Gy per fraction. Other patients had been treated with modified schedules of 25.05 Gy at 1.67 Gy per fraction (n=15) and 25.2 Gy at 1.8 Gy per fraction (n=11).
RESULTS
With a median follow-up of 112 months, the 5-year and 10-year survival rates were 100% and 96%, respectively, and 5-year and 10-year relapse-free survival rates were both 97.1%. No in-field recurrence occurred. Contralateral seminoma occurred in one patient 5 years after treatment. No grade III-IV acute toxicity occurred. An increased rate of grade 1-2 acute hematologic toxicity was found in patients with longer overall treatment times due to 1.5 Gy per fraction. The rate of grade 2 acute gastrointestinal toxicity was significantly higher with DL field than with PA field and also higher in the 1.8-Gy group than in the 1.5-Gy and 1.67-Gy groups.
CONCLUSION
Patients with stage I seminoma were safely treated with PA-only radiotherapy with no pelvic failure. Optimal fractionation schedule needs to be explored further in order to minimize treatment-related toxicity.

Keyword

Testicular seminoma; para-aortic radiotherapy; late complication; secondary malignancy

MeSH Terms

Adult
Disease-Free Survival
Dose Fractionation
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local/pathology
Radiotherapy, Adjuvant/adverse effects
Seminoma/*radiotherapy
Testicular Neoplasms/*radiotherapy
Treatment Outcome
Young Adult

Figure

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  Fig. 1 (A) Dog-leg field and (B) paraaortic field.

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  Fig. 2 (A) Overall survival rate and (B) relapse-free survival rate of all patients.

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