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Being among the most radiosensitive tumours, radiation therapy has replaced retroperitoneal lymphadenectomy in the treatment of early-stage testicular seminoma. One hundred and sixty-one patients who were treated from 1975 through to 1991 with histologically confirmed testicular seminoma of stages I and II were analyses retrospectively. After high semicastration, 98 patients were treated by radiation therapy of regional lymph nodes and 63 patients received retroperitoneal lymphadenectomy. Until 1985 retroperitoneal lymphadenectomy was preferred, but after 1985 radiotherapy outweighed retroperitoneal lymphadenectomy. The follow-up ranged from 11 months to 13.5 years, with a median of 79 months. Retroperitoneally, in-field relapses occurred in 9.5% (6/63 patients) after retroperitoneal lymphadenectomy and in 2.0% (2/98 patients) after radiation therapy (Fisher exact test, p = 0.057). A trend to a higher frequency of retroperitoneal relapses after retroperitoneal lymphadenectomy seemed to be apparent. Relapses outside the operation site or radiation fields were registered with non-significantly different frequencies (p = 0.741) of 4.8% (3/63 patients) and 7.1% (7/98 patients), respectively. Relapses increased from 4.1% for stage I (5/121 patients) up to 58.3% for stage IIC (7/12 patients).

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Among with surgery, biologically effective dose strongly influences overall survival in patients treated for pancreatic carcinoma. Treatment volume should be kept as small as possible and all efforts should be made to avoid treatment splits in radiation therapy.

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Background: Quality may be assured at 3 different levels: structure, process, and outcomes. In this paper we describe a method for assessing the quality of outcomes in the case of oncological recommendations for treatment. Material and Methods: For different therapies several goals were defined and the extent to which they were attained was evaluated. Several dimensions of the treatment goal were distinguished: the direction, specification and quantification of the goal. The direction may be either cure or palliation. If the goal is cure, the prolongation of life is intended. In the case of palliation as goal it should be specified whether alleviation of existing symptoms or prevention of impending problems is desired. Results: Based on 85 treatment recommendations provided by the Interdisciplinary Oncologic Conference of the Cancer Center University of Ulm we were able to demonstrate that a specification of palliative therapy was performed in 60% of all recommendations. The intended goal could actually be realized in half of these cases, i.e. in 30%. Conclusions: These data show that analysis of palliative therapy is a useful aid for assessing the rate of goal achievement and for modifying either the goals or the treatment if considered necessary.

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