What is the optimal management of recurrent seminoma with small volume retroperitoneal disease initially managed with surveillance?

Topics: Radiation Oncology • Genitourinary Cancers • Medical Oncology • Testicular Cancer

How does your approach differ for patients with stage IIA versus IIB disease? Age?

Answer from: Medical Oncologist at Community Practice

The question is how to manage pathologic confirmed CSII seminoma. If the nodal volume is on the larger side (> 3 or so cm), most experts would treat those patients with BEP X 3 with a very high cure rate, with very low likelihood of requiring any post-chemotherapy interventions. Most expe...

Comments

Medical Oncologist at Cleveland Clinic
My practice is similar to that described above. An...

Medical Oncologist at Virginia Cancer Spclsts PC
Off trial chemo or radiation. I'm not sure about E...

Medical Oncologist at Testicular Cancer Commons
Read Loehrer et al and Culine et al. If there are ...

Answer from: Radiation Oncologist at Community Practice

We would treat stage IIA with RT alone with 20 Gy in 10 fractions to the PA nodes and ipsilateral pelvis followed by 2x5 Gy boost to involved node with a 3D technique. For IIB, if it is lower volume (closer to 2 cm), we would do same as above, with a boost dose of 2x8. If it is closer to 5cm, then w...

Answer from: Radiation Oncologist at Academic Institution

I would be interested in the data suggesting BEP x 3 to be preferred to 20Gy of RT with a cone-down boost to 30Gy in this patient population. Not a medical oncologist, but BEP is quite toxic isn't it? Likely more so than 20Gy of radiation with a small area around gross disease getting 30Gy?

Comments

Medical Oncologist at Testicular Cancer Commons
There has never been and never will be a head to h...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
I would be interested in seeing data on relapse ra...

Medical Oncologist at Testicular Cancer Commons
Most people who get BEP are able to go to work or ...

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