RESULTS OF TREATMENT FOR PURE CLASSICAL SEMINOMA OF THE TESTIS

Abstract

Fifty-two cases of pure seminoma of the testis were treated in our hospital between 1964 and 1974.
Our treatment planning was that a radical orchiectomy was followed by radiation therapy. Radiation for stage I disease was given to the ipsilateral iliac and bilateral paraaortic caval nodes to the crura of the diaphragm. A dose from 2, 500 to 3, 000rad was given for three weeks. In stage II disease the bilateral iliac and paraaortic caval nodes were irradiated to a dose from 3, 000 to 4, 000rad over three to four weeks. Prophylactic mediastinal or supraclavicular radiation was also given.
Our experience with seminoma shows that radiation therapy seems to be satisfactory for N0 and N1 disease and unsatisfactory for N2 and M1 cases. Five year survival rate is 100 per cent for N0 and N1 lesions in 42 cases. Five year survival rate of 4 cases with N2 lesions in 25 per cent. Only one of 6 cases with M1 lesions survived more than 5 years (16 per cent). Conventional radiation therapy for stage III was disappointed. One of stage II cases with bulk disease could be cured by the treatment of combination of radiation and chemotherapy with Z 4942, followed by administration of 100mg of cyclophosphamide for 2 years.
We believe that it is necessary to give combination therapy of radiation and alkylating agents to advanced seminoma.