Low-dose radiation therapy for testicular intraepithelial neoplasia.
Four patients with unilateral testicular germ-cell tumor and biopsy-proven contralateral testicular intraepithelial neoplasia (TIN; so-called carcinoma in situ) received localized low-dose radiation therapy (18-20 Gy) of the testis with TIN. Repeated biopsies disclosed the disappearance of TIN and germ cells. No recurrence of TIN or germ cells was observed after a follow-up of 18-42 months. All patients reported a normal sex life without need of androgen supplementation. Serum follicle-stimulating hormone increased significantly immediately after radiation treatment and started to decline after 24 months. Serum luteinizing hormone increased slightly but not significantly. A decline after 24 months was observed in only one of three patients. Serum testosterone decreased significantly in all patients after 1 year but never became subnormal. Low-dose radiation treatment is efficacious in eradicating testicular intraepithelial neoplasia without destroying Leydig cells or stromal cells of the testis. Thus, a patient otherwise destined to develop a second testicular tumor can be spared orchiectomy and life-long hormonal replacement.
Department of Urology, Universitätklinikum Steglitz, Freie Universität Berlin, Federal Republic of Germany.
K P
KP
Dieckmann
A
A
Besserer
V
V
Loy
D000328:Adult; D001706:Biopsy; D002278:Carcinoma in Situ / Q000473:pathology / Q000532:radiotherapy*; D005069:Evaluation Studies as Topic; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000532:radiotherapy*; D013736:Testicular Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone