Radiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party.

2.50
Hdl Handle:
http://hdl.handle.net/10541/94751
Title:
Radiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party.
Authors:
Duchesne, G; Stenning, S; Aass, N; Mead, G; Fosså, S; Oliver, R; Horwich, A; Read, G; Roberts, I; Rustin, G; Cullen, M; Kaye, Stan B; Harland, S; Cook, P
Abstract:
In a retrospective study, data from 302 patients with metastatic testicular seminoma treated with chemotherapy between 1978 and 1990 in 10 European centres were analysed to evaluate the role, if any, of postchemotherapy treatment with irradiation. The primary endpoint of this study was the progression-free survival rate after chemotherapy with or without additional radiotherapy. This was related to the type of primary chemotherapy, sites and sizes of pre- and postchemotherapy masses, the extent of surgical resection after chemotherapy and the use of radiotherapy. 174 patients had residual disease at the end of chemotherapy. The most important prognostic factors for progression were the presence of any visceral metastases or raised LDH prechemotherapy, and the presence of residual disease at visceral sites after chemotherapy. Approximately half the patients with residual masses underwent postchemotherapy radiotherapy, with selection based predominantly on institutional practice. In patients receiving platinum-based chemotherapy, no significant difference was detected in progression-free survival whether or not radiotherapy was employed. Patients receiving BEP (bleomycin, etoposide and cisplatin) had a progression-free survival rate of 88% (95% CI, 80-96%) uninfluenced by postchemotherapy radiotherapy. In patients with residual masses confined to the abdomen after platinum-based chemotherapy, the absolute benefit to radiotherapy was estimated to be 2.3%. The potential benefit of postchemotherapy radiotherapy is minimal, and so it is concluded that the use of adjuvant radiotherapy to residual masses after platinum-based chemotherapy for metastatic seminoma is unnecessary.
Affiliation:
Department of Oncology, UCL Medical School, Middlesex Hospital, London, U.K.
Citation:
Radiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party. 1997, 33 (6):829-35 Eur J Cancer
Journal:
European Journal of Cancer
Issue Date:
May-1997
URI:
http://hdl.handle.net/10541/94751
DOI:
10.1016/S0959-8049(97)00033-6
PubMed ID:
9291801
Type:
Article
Language:
en
ISSN:
0959-8049
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorDuchesne, Gen
dc.contributor.authorStenning, Sen
dc.contributor.authorAass, Nen
dc.contributor.authorMead, Gen
dc.contributor.authorFosså, Sen
dc.contributor.authorOliver, Ren
dc.contributor.authorHorwich, Aen
dc.contributor.authorRead, Gen
dc.contributor.authorRoberts, Ien
dc.contributor.authorRustin, Gen
dc.contributor.authorCullen, Men
dc.contributor.authorKaye, Stan Ben
dc.contributor.authorHarland, Sen
dc.contributor.authorCook, Pen
dc.date.accessioned2010-03-23T17:03:38Z-
dc.date.available2010-03-23T17:03:38Z-
dc.date.issued1997-05-
dc.identifier.citationRadiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party. 1997, 33 (6):829-35 Eur J Canceren
dc.identifier.issn0959-8049-
dc.identifier.pmid9291801-
dc.identifier.doi10.1016/S0959-8049(97)00033-6-
dc.identifier.urihttp://hdl.handle.net/10541/94751-
dc.description.abstractIn a retrospective study, data from 302 patients with metastatic testicular seminoma treated with chemotherapy between 1978 and 1990 in 10 European centres were analysed to evaluate the role, if any, of postchemotherapy treatment with irradiation. The primary endpoint of this study was the progression-free survival rate after chemotherapy with or without additional radiotherapy. This was related to the type of primary chemotherapy, sites and sizes of pre- and postchemotherapy masses, the extent of surgical resection after chemotherapy and the use of radiotherapy. 174 patients had residual disease at the end of chemotherapy. The most important prognostic factors for progression were the presence of any visceral metastases or raised LDH prechemotherapy, and the presence of residual disease at visceral sites after chemotherapy. Approximately half the patients with residual masses underwent postchemotherapy radiotherapy, with selection based predominantly on institutional practice. In patients receiving platinum-based chemotherapy, no significant difference was detected in progression-free survival whether or not radiotherapy was employed. Patients receiving BEP (bleomycin, etoposide and cisplatin) had a progression-free survival rate of 88% (95% CI, 80-96%) uninfluenced by postchemotherapy radiotherapy. In patients with residual masses confined to the abdomen after platinum-based chemotherapy, the absolute benefit to radiotherapy was estimated to be 2.3%. The potential benefit of postchemotherapy radiotherapy is minimal, and so it is concluded that the use of adjuvant radiotherapy to residual masses after platinum-based chemotherapy for metastatic seminoma is unnecessary.en
dc.language.isoenen
dc.subjectAbdominal Canceren
dc.subjectTesticular Canceren
dc.subject.meshAbdominal Neoplasms-
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBleomycin-
dc.subject.meshCisplatin-
dc.subject.meshDisease Progression-
dc.subject.meshEtoposide-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshRadiotherapy, Adjuvant-
dc.subject.meshRetrospective Studies-
dc.subject.meshSeminoma-
dc.subject.meshSurvival Rate-
dc.subject.meshTesticular Neoplasms-
dc.subject.meshTreatment Outcome-
dc.titleRadiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party.en
dc.typeArticleen
dc.contributor.departmentDepartment of Oncology, UCL Medical School, Middlesex Hospital, London, U.K.en
dc.identifier.journalEuropean Journal of Canceren

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