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Low-dose radiotherapy for Stage I seminoma-long-term results

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  • Low-dose radiotherapy for Stage I seminoma-long-term results

    Int J Radiat Oncol Biol Phys. 2006 Sep 15; [Epub ahead of print]

    Low-dose radiotherapy for Stage I seminoma-long-term results.Niewald M, Freyd J, Fleckenstein J, Wullich B, Rube C.
    Department of Radiooncology, Saarland University Hospital, Homburg, Germany.

    PURPOSE: The aim of this study was to review retrospectively the results of low-dose radiotherapy for Stage I seminoma using four different fractionation schedules and target volume definitions. METHODS AND MATERIALS: A total of 191 patients underwent irradiation for histologically proven Stage I seminoma after undergoing an inguinal orchiectomy. Fractionation schedules were used one after another as follows: Total dose 30 Gy (dose/fraction 1.5 Gy, 16 patients), total dose 25.5 Gy (dose/fraction 1.5 Gy, 62 patients), total dose 20 Gy (dose/fraction 2 Gy, 69 patients), total dose 26 Gy (dose/fraction 2 Gy, 29 patients). The remaining 12 patients were excluded from this study. In the same period the target volume was gradually reduced. In 1983 the paraaortic, pelvic and inguinal regions were irradiated; later the target volume was reduced to the paraaortic region exclusively. RESULTS: Overall survival and event-free survival were identical in all groups ranging from 95% to 100% /5 years. Three patients experienced a lymph node metastasis during follow-up, 3 patients a distant metastasis to the lung and the bones. Mild acute side effects were noted in 8% to 15% of the patients, and very mild long-term side effects in 1% to 5% of patients. Multivariate analysis showed no prognostic significance of total dose, dose per fraction, or target volume. In univariate analysis, a higher frequency of acute side effects to the skin and the bowel was related to a higher total dose, and an elevated frequency of nausea was related to a higher daily dose per fraction. CONCLUSION: Using lower doses and limiting the target volume to the paraaortic region exclusively did not result in a worse prognosis in our patient series.

    PMID: 16979844 [PubMed - as supplied by publisher]
    Retired moderator. Husband, left I/O 16Dec2005, stage I seminoma with elevated b-HCG, no LVI, RTx15 (25Gy). All clear ever since.