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Terbuch, A; Posch, F; Bauernhofer, T; Jost, PJ; Partl, R; Stranzl-Lawatsch, H; Baciarello, G; Fizazi, K; Giannatempo, P; Verzoni, E; Sweeney, C; Ravi, P; Tran, B; Basso, U; White, J; Vincenzi, B; Oing, C; Cutuli, HJ; Dieckmann, KP; Gamulin, M; Chovanec, M; Fankhauser, CD; Heidenreich, A; Mohamad, O; Thibault, C; Fischer, S; Gillessen, S, , International, Germ, Cell, Cancer, Collaborative, Group.
Patterns of Disease Progression and Outcome of Patients With Testicular Seminoma Who Relapse After Adjuvant or Curative Radiation Therapy.
Int J Radiat Oncol Biol Phys. 2022; 113(4):825-832 Doi: 10.1016/j.ijrobp.2022.03.021
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Führende Autor*innen der Med Uni Graz
Terbuch Angelika
Co-Autor*innen der Med Uni Graz
Bauernhofer Thomas
Jost Philipp
Partl Richard
Posch Florian
Stranzl-Lawatsch Heidi
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Abstract:
PURPOSE: Radiation therapy is a possible treatment strategy for patients with testicular seminoma after orchiectomy in clinical stage I or II disease. Little is known about the outcome of patients who experience a relapse after radiation therapy. METHODS AND MATERIALS: Data from 61 patients who relapsed after adjuvant or curative radiation therapy from 17 centers in 11 countries were collected and retrospectively analyzed. Primary outcomes were disease-free and overall survival. Secondary outcomes were time to relapse, stage at relapse, treatment for relapse, and rate of febrile neutropenia during chemotherapy for relapse. RESULTS: With a median follow-up of 9.9 years (95% confidence interval [CI], 7.5-10.9), we found a 5-year disease-free survival of 90% (95% CI, 79-95) and a 5-year overall survival of 98% (95% CI, 89-100). Sixty-six percent of patients had stage III disease at time of relapse and 93% of patients fell into the good prognosis group per the International Germ Cell Cancer Collaborative Group classification. The median time to relapse after radiation therapy was 15.6 months (95% CI, 12-23). Twenty-two (36%) patients relapsed more than 2 years after radiation therapy and 7 (11.5%) patients relapsed more than 5 years after radiation therapy. One-third of relapses was detected owing to patients' symptoms, whereas two-thirds of relapses were detected during routine follow-up. The majority (93%) of cases were treated with cisplatin-based chemotherapy. The rate of febrile neutropenia during chemotherapy was 35%. Five patients experienced a second relapse. At last follow-up, 55 patients (90%) were alive without disease. Only 1 patient died owing to disease progression. CONCLUSIONS: Cisplatin-based chemotherapy for patients with seminoma who have relapsed after treatment with radiation therapy alone leads to excellent outcomes. Patients and physicians should be aware of possible late relapses after radiation therapy.
Find related publications in this database (using NLM MeSH Indexing)
Chemotherapy, Adjuvant - administration & dosage
Cisplatin - therapeutic use
Disease Progression - administration & dosage
Febrile Neutropenia - drug therapy
Follow-Up Studies - administration & dosage
Humans - administration & dosage
Male - administration & dosage
Neoplasm Recurrence, Local - radiotherapy
Neoplasm Staging - administration & dosage
Orchiectomy - administration & dosage
Retrospective Studies - administration & dosage
Seminoma - drug therapy, radiotherapy
Testicular Neoplasms - drug therapy, radiotherapy

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