Radiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party.
Authors
Duchesne, GStenning, 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
Affiliation
Department of Oncology, UCL Medical School, Middlesex Hospital, London, U.K.Issue Date
1997-05
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Show full item recordAbstract
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.Citation
Radiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party. 1997, 33 (6):829-35 Eur J CancerJournal
European Journal of CancerDOI
10.1016/S0959-8049(97)00033-6PubMed ID
9291801Type
ArticleLanguage
enISSN
0959-8049ae974a485f413a2113503eed53cd6c53
10.1016/S0959-8049(97)00033-6
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