Randomized Trial of Carboplatin Versus Radiotherapy for Stage I Seminoma: Mature Results on Relapse and Contralateral Testis Cancer Rates in MRC TE19/EORTC 30982 Study (ISRCTN27163214)

Oliver, R. T. D.; Mead, G. M.; Rustin, G. J. S.; Joffe, Johnathan; Aass, Nina; Coleman, Robert L.; Gabe, Rhian; Pollock, Philip; Stenning, Sally

doi:10.1200/jco.2009.26.4655

Cited by 280 publications

(141 citation statements)

References 31 publications

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“…Clinical data are suggestive of a dose-response curve across therapeutically deliverable doses of carboplatin (4). Consistent with these data, an exploratory analysis of the MRC TE19/EORTC 30982 study, a randomized trial comparing carboplatin with radiotherapy (RT) as adjuvant treatment for stage I seminoma, found a higher risk of relapse in patients where carboplatin dose was calculated based on creatinine clearance with an arbitrary 10% dose reduction applied, in comparison to those patients dosed according to isotopic GFR (3). This highlights the importance of accurate assessment of GFR and hence carboplatin dose in this setting.…”

Section: Introductionmentioning

confidence: 49%

“…The management of stage 1 seminoma historically included adjuvant radiotherapy, however following orchidectomy, cases can be managed by surveillance alone or single agent carboplatin adjuvant therapy (2)(3). Carboplatin is a platinum based alkylating agent that interferes with DNA processes and is used in the treatment of several malignancies (4).…”

Section: Introductionmentioning

confidence: 99%

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Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma

Shepherd

Gillen

Morrison

et al. 2014

European Journal of Cancer

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Section: Introductionmentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma

Shepherd

Gillen

Morrison

et al. 2014

European Journal of Cancer

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“…Currently, monochemotherapy with carboplatin may be proposed as the third approach. The role of adjuvant monochemotherapy with carboplatin is less established (15)(16)(17).…”

Section: Resultsmentioning

confidence: 99%

Side Effects of Adjuvant Radiotherapy in Men with Testicular Seminoma Stage I

Gamulin

Grgić

Bišof

2011

Archives of Industrial Hygiene and Toxicology

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In this study we followed up the side effects of adjuvant radiotherapy in patients with testicular seminoma stage I over a period from 13 to 84 months (median 28 months). The most frequent side effects during radiotherapy were gastrointestinal (nausea/vomiting), psychological, cognitive, and minor sexual problems. The reported side effects were treated by antiemetics and anxiolytics. After radiotherapy, the side effects persisted in 6 % of patients, but only a few of them required additional treatment. Healthy children were born to 76 % of patients in the 18 to 39 years age group. This study shows that adjuvant radiotherapy of the para-aortic lymph nodes with the total dosage of 24 Gy in 16 daily fractions administered to testicular seminoma patients causes acceptable side effects, does not adversely affect quality of life and fertility, if the approach to treatment is individual and family consulting is provided. This makes adjuvant radiotherapy of the para-aortic lymph nodes an acceptable treatment for testicular seminoma stage I patients. Testicular germ cell tumours are relatively rare, appearing in 1 % of all tumours in male patients (1). Most of these tumours originate in germ cells (seminoma and non-seminoma germ cell testicular tumours, sometimes the combination of these two groups), and more than 70 % of patients are diagnosed the disease while it is still in stage I. These malignancies represent the most common solid tumours in young men aged 25 to 35 years and are highly curable. KEY WORDS: early stage seminoma, follow-up, para-aortic radiotherapy, quality of life, radiation toxicityPure seminoma is the most common variant of testicular germ cell tumours, accounting for in about 40 % of all cases. Seminoma is highly radiosensitive and chemosensitive (2). Adjuvant radiotherapy of the para-aortic lymph nodes after orchidectomy is one of the three approaches to management, which include surveillance, adjuvant radiotherapy (infradiaphragmatic 20 Gy to 25 Gy to include the para-aortic nodes), and adjuvant chemotherapy with carboplatin with area under the curve =7, (AUC=7) x 1 cycle or AUC=7 x 2 cycles (3-6).Many surveillance studies suggest that 15 % to 20 % of these patients develop a metastatic disease. The adjuvant therapy is successful in 96 % to 100 % of patients (4,7,8). Many studies suggest that carboplatin is not inferior to adjuvant radiotherapy in preventing metastatic relapse. The estimation of the therapy success, however, should include the quality of life during as well as after therapy. To improve the quality of life , it is therefore advisable to know which side effects to expect and how to prevent them).

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“…Es gibt hier zwei äquivalente Therapie-Optionen: 1) Über-wachung, 2) eine Zyklus-adjuvante Chemotherapie mit Carboplatin AUC7 [4]. Diese einmalig applizierte Chemotherapie ist mit sehr wenig Toxizität verbunden und wird von diesen meist sehr jungen Patienten bestens vertragen.…”

Section: Seminom Csiunclassified

Diagnostik, Therapie und Nachsorge beim Hodenkarzinom

Kälin

Mauti

Pless

2016

Praxis

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Zusammenfassung. Keimzelltumoren repräsentieren eine seltene Neoplasie, die meist Männer im Alter zwischen 15 und 40 Jahren betrifft. Zu etwa 50 % handelt es sich bei Hodenkarzinomen um reine Seminome, die 50 % Nicht-Seminome stellen eine heterogene Entität dar. Die initiale Therapie ist meist die Orchiektomie, das weitere Vorgehen hängt von der Histologie, vom Tumorstadium und vom Risikoprofil ab. Engmaschige Überwachung, Radiotherapie oder Chemotherapie sind die therapeutischen Optionen. Im Stadium I beträgt die Heilungsrate praktisch 100 %, aber auch im metastasierten Stadium können immer noch mehr als 80 % der Patienten geheilt werden. Sie müssen aber in einer langjährigen Nachsorge bleiben und speziell auf kardiovaskuläre Risikofaktoren kontrolliert werden.

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Randomized Trial of Carboplatin Versus Radiotherapy for Stage I Seminoma: Mature Results on Relapse and Contralateral Testis Cancer Rates in MRC TE19/EORTC 30982 Study (ISRCTN27163214)

Abstract: These updated results confirm the noninferiority of single dose carboplatin (at 7 × AUC dose) versus RT in terms of RFR and establish a statistically significant reduction in the medium term of risk of second GCT produced by this treatment.

Cited by 280 publications

References 31 publications

Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma

Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma

Side Effects of Adjuvant Radiotherapy in Men with Testicular Seminoma Stage I

Diagnostik, Therapie und Nachsorge beim Hodenkarzinom

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