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J Korean Soc Ther Radiol > Volume 12(3); 1994 > Article
Journal of the Korean Society for Therapeutic Radiology 1994;12(3): 361-368.
Radiation Therapy of Testicular Seminoma
Hong Gyun Wu, Do Hoon Oh, Sung Whan Ha
Department of Therapeutic Radiology Seoul National University college of medicine, Seoul, Korea.
Testicular seminomas are radiosensitive and adjuvant radiation therapy after orchiectomy results in long term survival in early stage diseases. Ten year results of radiation therapy after orchiectomy and results of definitive treatment of recurrent seminoma are presented.
Between August 1980 and February 1990, 32 patients with testicular seminomas were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. Twenty-seven patients received radiation therapy after orchiectomy and 5 patients for treatment of recurrent tumors. Two of postoperatively treated patients and 2 of recurrent patients were excluded from the study because of incomplete treatment. Of the patients treated postoperatively. 18 were stage I, 5 were stage IIA, one was stage IIB, and one was stage IIC. There were 4 ipsilateral and 2 contralateral cryptorchids. Preoperatively, b-HCG levels were elevated in 5 patients. Median dose to pelvic and paraaortic lymph node area was 2900 cGy (1550-4550 cGy). One patient with stage I, 4 with stage IIA, and 1 with stage IIB received prophylactic mediastinal irradiation. Two patients were treated with chemotherapy before radiation therapy. Median follow-up period was 104(3-144) months.
Local control rates were 100% at 5 years after orchiectomy. Five year survival rates were 94.4% in Stage I and 100% in Stage II patients. One patient with stageII disease died 3 months after surgery due to mediastinal metastasis. All the 3 patients treated for recurrent disease are alive without disease.
Postorchiectomy radiation to the pelvis and para-aortic area remains the treatment of choice for patient with early stage testicular seminoma. Radiation therapy is also an excellent treatment modality for recurrent seminoma.
Key Words: Seminoma, Postoperative radiotherapy, Recurrent seminoma
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