title: Radiotherapy for Stage IIA seminoma: The Northern Israel Oncology Center Experience, 1971-2010.
abstract: OBJECTIVE
  To evaluate treatment details, outcome, relapse rate and side-effects in Stage IIA seminoma irradiated and followed for a period of 39 years.
  
  
  BACKGROUND
  Seminoma is a very radiosensitive disease and radiation therapy alone is able to achieve long-term disease-free survival, even in advanced Stage disease. Due to the lack of long-term prospective studies, it is of value to follow patients and try to determine the appropriate volume to be irradiated and the dose which can achieve total cure with minimal acute and chronic side-effects.
  
  
  METHODS
  A retrospective review of 24 Stage IIA seminoma patients irradiated between 1971 and 2010 was performed. All patients underwent orchiectomy and meticulous clinical, biochemical and radiological staging.
  
  
  RESULTS
  Median age at diagnosis was 36 years and median follow-up was 84 months. A majority of patients received the "hockey-stick" irradiation schedule (para-aortic lymph nodes and hemi-pelvis) to a total dose of 2250-2500 cGy and a boost to radiologically involved nodes of 500-1000 cGy. Treatment was well-tolerated. Twenty-one (88%) patients are alive with no evidence of disease. Two patients died due to unknown causes, while one patient died due to head of the pancreas carcinoma, most probably radiation-induced.
  
  
  CONCLUSIONS
  In Stage II seminoma, radiotherapy can provide excellent results with low rates of toxicity. Reduction of total dose and size of fields without affecting the good results should be considered. Due to prolonged survival, awareness of second primary tumor is indicated.
authors.affiliation: The Northern Israel Oncology Center, Rambam Health Care Campus and Faculty of Medicine, Haifa, Israel.
authors.forename: Moshe E
authors.initials: ME
authors.lastname: Stein
authors.affiliation: Department of Oncology, Safed Medical Center, Safed, and Israel Faculty of Medicine in the Galilee, Bar-Ilan University, Israel.
authors.forename: Jamal
authors.initials: J
authors.lastname: Zidan
authors.affiliation: The Northern Israel Oncology Center, Rambam Health Care Campus and Faculty of Medicine, Haifa, Israel.
authors.forename: Tomer
authors.initials: T
authors.lastname: Charas
authors.affiliation: The Northern Israel Oncology Center, Rambam Health Care Campus and Faculty of Medicine, Haifa, Israel.
authors.forename: Rahamim
authors.initials: R
authors.lastname: Ben-Yosef
keywords: Long-term survival; Radiation therapy; Stage IIA seminoma