[Evidence based medicine indications for radiation therapy in testicular germ cell tumours].

Abstract

The intensity of adjuvant radiotherapy for stage I seminoma could be reduced substantially in recent years, achieving cure with low side effects and a low probability of late complications. Today a dose of 20 Gy is applied to the para-aortic lymphatics. Valuable treatment alternatives to radiotherapy have emerged: surveillance strategy allows 80% of patients to avoid further treatment. However, the remaining 20% will be exposed to potentially more intensive salvage therapy. Adjuvant carboplatinum chemotherapy offers similar disease-free survival to adjuvant radiotherapy. Long-term experience with late toxicity is not available. In seminoma CS IIA/B curative irradiation remains the standard treatment. Brain metastases of testicular germ cell tumors are treated with a combination of chemotherapy and cranial irradiation. In intratubular germ cell neoplasia (TIN), radiotherapy with 20 Gy will safely eliminate all TIN loci, but will destroy potential residual fertility.

• Authors: R Souchon, J Classen, H Schmidberger
• Journal: Der Urologe. Ausg. A (Urologe A) Vol. 43 Issue 12 Pg. 1500-6 (Dec 2004) ISSN: 0340-2592 [Print] Germany
• Vernacular Title: EbM-basierte Indikationen zur Radiotherapie von testikulären Keimzellmalignomen.
• PMID: 15502911 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (therapeutic use)
• Brain Neoplasms (drug therapy, radiotherapy, secondary)
• Clinical Trials as Topic
• Evidence-Based Medicine
• Humans
• Male
• Neoplasms, Germ Cell and Embryonal (drug therapy, radiotherapy, secondary)
• Practice Guidelines as Topic
• Practice Patterns, Physicians'
• Radiotherapy (methods)
• Radiotherapy, Adjuvant (methods)
• Risk Assessment (methods)
• Risk Factors
• Testicular Neoplasms (drug therapy, radiotherapy)
• Treatment Outcome