ANALYSIS OF TREATMENT AND CONTROVERSIES IN STAGE I-II TESTICULAR SEMINOMA

Results of treatment in 58 cases with pure testicular seminoma treated in Department of Radiation Oncology of Cerrahpaşa Medical Faculty between the years of 1978-1986 were reported. Patients were treated with Co60 or 9 MeV linear accelerators. In all cases 3600-4000 cGy were given in 20 fractions to iliac and paraaortic regions. In addition 65 % (11/17) of stage II A and 58 % (7/12) of stage II B cases received prophylactic mediastinal and supraclavicular irradiation. The 2 and 5-year survival rates for the entire group was 84 and 82 %. For stage I, it was 96 and 92 % and stage 11-72 %. In stage II cases prognosis was worse when palpabl abdominal disease was present. Five-year survival rate was found to be 88 % for stage II A and 50 % for stage II B. This difference is statistically significant (p <0.05). Prophylactic mediastinal irradiation did not produce a benefit in stage II cases. Although relapse rate was more common in the group receiving paraaortic and pelvic irradiation only, this difference is not statistically significant. This report has reviewed the current controversies in the management of stage I and II testicular seminoma.