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Radiotherapy for Stage IIA seminoma: The Northern Israel Oncology Center Experience, 1971–2010
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Abstract
Aim
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.
Patients and 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[[ce:hsp sp="0.25"/]]cGy and a boost to radiologically involved nodes of 500–1000[[ce:hsp sp="0.25"/]]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.
Abstract
Aim
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.
Patients and 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[[ce:hsp sp="0.25"/]]cGy and a boost to radiologically involved nodes of 500–1000[[ce:hsp sp="0.25"/]]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.
Keywords
Long-term survival; Radiation therapy; Stage IIA seminoma


Title
Radiotherapy for Stage IIA seminoma: The Northern Israel Oncology Center Experience, 1971–2010
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
281-286
Published online
2014-09-01
DOI
10.1016/j.rpor.2014.02.004
Bibliographic record
Rep Pract Oncol Radiother 2014;19(5):281-286.
Keywords
Long-term survival
Radiation therapy
Stage IIA seminoma
Authors
Moshe E. Stein
Jamal Zidan
Tomer Charas
Rahamim Ben-Yosef