Radiology, Vol 123, 175-180, Copyright © 1977 by Radiological Society of North America
The role of radiation therapy in the treatment of germinal cell tumors of the testis other than pure seminoma
DH Hussey, KH Luk and DE Johnson
Between March 1944 and September 1976, 279 patients with nonseminomatous
testicular tumors were treated. The 3-year NED rates for patients with
Stages I, IIA, and IIB were 78.2%, 46.7%, and 17.6%, respectively. However,
the results were better for patients treated with preoperative radiotherapy
and lymphadenectomy with or without postoperative radiotherapy (Stage IIA:
77.5%--14/18; Stage IIB: 12.9%-- 3/7). Postoperative radiotherapy is not
necessary for patients with negative nodes at lymphadenectomy because the
periaortic failure rate is low for this group. However, when positive nodes
are found, the control is improved with radiotherapy. The minimum tumor
dose required when tumor is found but resected is not known. When there is
gross residual tumor, a dose of 4,500-5,500 rad is required to achieve any
salvage. In this series, 42.2% of patients with positive nodes at
lymphadenectomy (Stages I and II) developed extranodal metastases. This
group might benefit from adjunctive chemotherapy.
