[Evidence based medicine indications for radiation therapy in testicular germ cell tumours].
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.
Souchon
R
R
Klinik für Strahlentherapie und Radioonkologie des Allgemeinen Krankenhauses Hagen gGmbH, Universität Witten/Herdecke. souchon@akh-hagen.de
Classen
J
J
Schmidberger
H
H
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary; D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011878:Radiotherapy / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents