Changes to This Summary (04/02/2014)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1).
Revised text to state that because the majority of testis cancer patients who receive adjuvant chemotherapy or radiation therapy are curable, it is necessary to be aware of possible long-term effects of the various treatment modalities.
Added text about treatment options when the surveillance strategy is not acceptable. For patients who are uncomfortable with surveillance and wish to minimize the risk of relapse, radical inguinal orchiectomy followed by radiation therapy or one or two doses of carboplatin adjuvant therapy may be used, but there is controversy about which of those strategies is preferred (cited Bosl et al. as reference 9).
Revised text to state that relapse rates and toxic effects were studied in a randomized comparison (MRC-TE10) of para-aortic radiation therapy alone versus para-aortic radiation therapy with an added ipsilateral iliac lymph node field (cited Mead et al. as reference 17). Five-year relapse-free survival (RFS) rates were virtually identical as were overall survival (OS) rates.
Revised text to state that in a randomized trial (MRC-TE18), a radiation dose of 20 Gy over 10 daily fractions was clinically equivalent to 30 Gy over 15 fractions after a median follow-up of 7 years in both RFS and OS.
Revised text to state that in a large, randomized, controlled, noninferiority trial (MRC-TE19), 1,477 men with stage I seminoma were randomly assigned to undergo para-aortic radiation therapy or to receive a single dose of carboplatin after radical inguinal orchiectomy; study participants were followed up for a median of 6.5 years. Also added text about the RFS rates at 5 years in the carboplatin and radiation therapy arms and the reduced number of contralateral testicular germ cell tumors in the carboplatin arm (added level of evidence 1iiA).
Editorial changes were made to this section.
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.