title: Treatment of testicular intraepithelial neoplasia (intratubular germ cell neoplasia unspecified) with local radiotherapy or with platinum-based chemotherapy: a survey of the German Testicular Cancer Study Group.
abstract: BACKGROUND
  The treatment of testicular intraepithelial neoplasia (TIN), the progenitor of testicular germ cell tumours (GCTs), is based on little data.
  
  
  METHODS
  Two hundred and twenty-eight GCT patients with contralateral TIN were retrospectively enrolled. Ten had surveillance, 122 radiotherapy to testis with 18-20 Gy, 30 cisplatin-based chemotherapy (two cycles), 51 chemotherapy (three cycles), and 15 carboplatin. The study end point was a malignant event (ME), defined as detection of TIN upon control biopsy or occurrence of a second GCT. The Secondary end point was hypogonadism during follow-up.
  
  
  RESULTS
  Numbers, proportions of ME, and median event-free survival (EFS) times were: radiotherapy N = 3, 2.5%, 11.08 years; chemotherapy (two cycles) N = 15, 50%, 3.0 years; chemotherapy (three cycles) N = 12, 23.5%, 9.83 years; carboplatin N = 10, 66%, 0.9 years; surveillance N = 5, 50%, 7.08 years. EFS is significantly different among the groups. Hypogonadism rates were in radiotherapy patients 30.8%, chemotherapy (two cycles) 13%, chemotherapy (three cycles) 17.8%, carboplatin 40%, surveillance 40%.
  
  
  CONCLUSIONS
  Local radiotherapy is highly efficacious in curing TIN. Chemotherapy is significantly less effective and the cure rates are dose-dependent. Though hypogonadism occurs in one-third of patients, radiotherapy with 20 Gy remains the standard management of TIN.
authors.affiliation: Department of Urology, Albertinen-Krankenhaus, Hamburg, Germany. dieckmannkp@t-online.de
authors.forename: K-P
authors.initials: KP
authors.lastname: Dieckmann
authors.forename: S
authors.initials: S
authors.lastname: Wilken
authors.forename: V
authors.initials: V
authors.lastname: Loy
authors.forename: C
authors.initials: C
authors.lastname: Matthies
authors.forename: K
authors.initials: K
authors.lastname: Kleinschmidt
authors.forename: J
authors.initials: J
authors.lastname: Bedke
authors.forename: A
authors.initials: A
authors.lastname: Martinschek
authors.forename: R
authors.initials: R
authors.lastname: Souchon
authors.forename: U
authors.initials: U
authors.lastname: Pichlmeier
authors.forename: S
authors.initials: S
authors.lastname: Kliesch
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000627:therapeutic use; D018572:Disease-Free Survival; D006801:Humans; D007006:Hypogonadism; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin