Controversy over radiotherapy in 1 stage seminomas

Abstract

In the past years efforts have been made to find the least eradicating methods of complementary therapy in the treatment of 1 st stage seminomas.

In the Polish centers, as in the majority of centers of the world, complementary irradiation of the lymphatic system is applied. The efficiency of this procedure (almost 100% of cured cases) causes that few centers decide to change the treatment.

Objective

comparison of the treatment of 1 st stage seminomas preceded by orchidectomy

• a)

  selective irradiation

• b)

  withdrawal from irradation – observation.

• Group A – 75 patients treated between 1977 and 1986 were irradiated.

• Group B – 31 patients treated between 1987 and 1991 were under constant observation.

The percentage of cases with a 5-year survival is convergent and independent of the applied method. Considering the fact that mainly young men are affected (18–35 years) treatment should be optimized during the most active part of their lives; after performing orchidectomy and detailed examinations (histopathology, CT, ultrasonography, markers) that is after excluding high risk factors – the patients should remain under observation.!!