Background: Extended field radiotherapy is a standard of care for low volume stage II testicular seminoma.
We hypothesized that neoadjuvant carboplatin might reduce the recurrence risk.
Patients and Methods: In a single-arm study, 51 patients were treated between May 1996 and November 2011 with a single cycle of carboplatin followed by radiotherapy. The radiation field was reduced from an extended abdomino-pelvic field to just the para-aortic region, and the radiation dose from 35 Gy to 30 Gy in 39 patients.
Results: After a median follow-up of 55 months (range 8-151 months) with 38 (74%) of the patients having been followed for >2 years, there have been no relapses (95% confidence limits of 5-year relapse-free survival of 93%-100%). Toxicity has been low with grade 3 toxicity limited to four patients with grade 3 haematological toxicity (with no clinical sequelae) and one patient with grade 3 nausea (during radiotherapy). No patients experienced grade 4 toxicity.
Conclusions: The results of this pilot study suggest that a single cycle of neoadjuvant carboplatin before radiotherapy may reduce recurrence risk compared with radiotherapy alone and permit a smaller radiation field, and this approach is proposed for further investigation.
Written by:
Horwich A, Dearnaley DP, Sohaib A, Pennert K, Huddart RA. Are you the author?
Division of Radiotherapy & Imaging, The Institute of Cancer Research and Urological Oncology Unit.
Reference: Ann Oncol. 2013 Apr 16. Epub ahead of print.
doi: 10.1093/annonc/mdt148
PubMed Abstract
PMID: 23592702
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