Neoadjuvant carboplatin before radiotherapy in stage IIA and IIB seminoma.

Abstract

BACKGROUND:

Extended field radiotherapy is a standard of care for low volume stage II testicular seminoma. We hypothesized that neoadjuvant carboplatin might reduce the recurrence risk.

PATIENTS AND METHODS:

In a single-arm study, 51 patients were treated between May 1996 and November 2011 with a single cycle of carboplatin followed by radiotherapy. The radiation field was reduced from an extended abdomino-pelvic field to just the para-aortic region, and the radiation dose from 35 Gy to 30 Gy in 39 patients.

RESULTS:

After a median follow-up of 55 months (range 8-151 months) with 38 (74%) of the patients having been followed for >2 years, there have been no relapses (95% confidence limits of 5-year relapse-free survival of 93%-100%). Toxicity has been low with grade 3 toxicity limited to four patients with grade 3 haematological toxicity (with no clinical sequelae) and one patient with grade 3 nausea (during radiotherapy). No patients experienced grade 4 toxicity.

CONCLUSIONS:

The results of this pilot study suggest that a single cycle of neoadjuvant carboplatin before radiotherapy may reduce recurrence risk compared with radiotherapy alone and permit a smaller radiation field, and this approach is proposed for further investigation.

• Authors: A Horwich, D P Dearnaley, A Sohaib, K Pennert, R A Huddart
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 24 Issue 8 Pg. 2104-7 (Aug 2013) ISSN: 1569-8041 [Electronic] England
• PMID: 23592702 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Carboplatin

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Carboplatin (therapeutic use)
• Combined Modality Therapy
• Disease-Free Survival
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local (drug therapy, prevention & control, radiotherapy)
• Neoplasm Staging
• Radiotherapy Dosage
• Seminoma (drug therapy, radiotherapy)
• Testicular Neoplasms (drug therapy, radiotherapy)
• Young Adult