Low-dose radiotherapy for Stage I seminoma-long-term results

Journal Article · Wed Nov 15 04:00:00 UTC 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.06.054· OSTI ID:20850228

Niewald, Marcus ^[1]; Freyd, Johanna ^[1]; Fleckenstein, Jochen ^[1]; Wullich, Bernd ^[2]; Ruebe, Christian ^[1]

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1. Department of Radiooncology, Saarland University Hospital, Homburg (Germany)
2. Departments of Urology and Pediatric Urology, Saarland University Hospital, Homburg (Germany)

Purpose: The aim of this study was to review retrospectively the results of low-dose radiotherapy for Stage I seminoma using four different fractionation schedules and target volume definitions. Methods and Materials: A total of 191 patients underwent irradiation for histologically proven Stage I seminoma after undergoing an inguinal orchiectomy. Fractionation schedules were used one after another as follows: Total dose 30 Gy (dose/fraction 1.5 Gy, 16 patients), total dose 25.5 Gy (dose/fraction 1.5 Gy, 62 patients), total dose 20 Gy (dose/fraction 2 Gy, 69 patients), total dose 26 Gy (dose/fraction 2 Gy, 29 patients). The remaining 12 patients were excluded from this study. In the same period the target volume was gradually reduced. In 1983 the paraaortic, pelvic and inguinal regions were irradiated; later the target volume was reduced to the paraaortic region exclusively. Results: Overall survival and event-free survival were identical in all groups ranging from 95% to 100% /5 years. Three patients experienced a lymph node metastasis during follow-up, 3 patients a distant metastasis to the lung and the bones. Mild acute side effects were noted in 8% to 15% of the patients, and very mild long-term side effects in 1% to 5% of patients. Multivariate analysis showed no prognostic significance of total dose, dose per fraction, or target volume. In univariate analysis, a higher frequency of acute side effects to the skin and the bowel was related to a higher total dose, and an elevated frequency of nausea was related to a higher daily dose per fraction. Conclusion: Using lower doses and limiting the target volume to the paraaortic region exclusively did not result in a worse prognosis in our patient series.

• OSTI ID: 20850228
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 66; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
FRACTIONATED IRRADIATION
LUNGS
LYMPH NODES
METASTASES
MULTIVARIATE ANALYSIS
NAUSEA
PATIENTS
RADIATION DOSES
RADIOTHERAPY
REVIEWS
SIDE EFFECTS
SKELETON
SKIN