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World Journal of Urology

Erschienen in:

18.11.2023 | Topic Paper

Advances in radiation therapy for testicular seminoma

verfasst von: Daniel B. Rosen, Arvin Jeremy N. Tan, Jennifer Pursley, Sophia C. Kamran

Erschienen in: World Journal of Urology | Ausgabe 12/2023

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Abstract

Purpose

Novel techniques and advances in radiation therapy (RT) have been explored to treat testicular seminoma, a highly radiosensitive and curable histology. We evaluated the historical and current indications for radiation therapy (RT) in testicular seminoma.

Methods

A narrative literature review was performed. Studies of RT for testicular seminoma were included. Additionally, recent trials testing the use of combination or surgical therapies for clinical stage (CS) II were included. Search parameters included radiation therapy, testicular seminoma, surgery, and chemoradiation. Parameters and outcomes assessed were progression-free survival (PFS), overall survival (OS), acute toxicities, long-term sequelae, and rates of secondary malignancies.

Results

Practice defining and changing studies in the use or omission of radiation therapy for testicular seminoma were identified along with resultant changes in National Comprehensive Cancer Network (NCCN) and European guidelines. Recent trials in combined chemoradiation and upfront surgical approaches to CS II disease were reviewed.

Conclusion

RT has historically been used as adjuvant treatment for CS I disease and is highly effective at treating CS II (A/B) testicular seminoma. The drive to maintain therapeutic efficacy and reduce acute and long-term side effects, namely secondary malignancies, is being tested using new radiation technologies, combined modality therapy in the form of chemoradiation and with upfront surgical approaches. Also, as guidelines now “strongly prefer” surveillance instead of adjuvant RT for CS I disease, the current CS II population comprises patients presenting with CS II disease (“de novo”) and those who present with CSII after relapsing post orchiectomy for CS I (“relapsed”). Emerging evidence suggests that these two groups have different outcomes with respect to RT and chemoradiation. Consequently, future trials may need to sub-stratify according to these groups.

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Titel: Advances in radiation therapy for testicular seminoma
verfasst von: Daniel B. Rosen
Arvin Jeremy N. Tan
Jennifer Pursley
Sophia C. Kamran
Publikationsdatum: 18.11.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 12/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04674-8

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Advances in radiation therapy for testicular seminoma

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Purpose

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Results

Conclusion

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