Long-term evaluation of postorchiectomy irradiation for stage I seminoma.

Abstract

To determine the late clinical effects of irradiation in stage I seminoma. From 1966 to 1991, 104 patients with stage I seminoma were treated and followed up. After inguinal orchiectomy, all underwent megavoltage infradiaphragmatic irradiation through a "hockey stick" field encompassing the periaortic and ipsilateral iliac lymph nodes (30 Gy in 1.5-Gy fractions). There were no serious, acute toxic effects or late complications. Three patients developed tumor recurrence at 9, 10, and 17 months; two had no evident disease 5 and 25 years after salvage chemotherapy and radiation therapy. Six patients developed second malignancies a mean of 10 years after treatment. None were considered to be radiation induced, and five of these patients had no evident disease after appropriate treatment. The first course of postorchiectomy irradiation controls stage I seminoma in most patients (101 of 104 [97.1%]) and causes no serious, acute toxic effects or late complications.