📃 Paper Title: Randomized Trial of 30 Versus 20 Gy in the Adjuvant Treatment of Stage I Testicular Seminoma: A Report on Medical Research Council Trial TE18, European Organisation for the Research and Treatment of Cancer Trial 30942 (ISRCTN18525328)
🧍 Author: Jones
🕒 Year: 2005
📚 Journal: Journal of Clinical Oncology
🌎 Country: United Kingdom
ㅤContext to the study:
Will you offer radiotherapy for stage 1 testicular seminoma?
ㅤ✅ Take-home message of study:
This randomised study compared the results of a standard dose of 30 Gy in 15 fractions of radiotherapy with the lower dose of 20 Gy in 10 fractions for stage 1 testicular seminoma.
20 Gy in 10 daily fractions over 2 weeks is an effective management strategy for stage I testicular seminoma. This regimen showed reduced acute morbidity, treatment-related lethargy, and the ability to carry out work at both 4 weeks and 12 weeks of follow-up. Relapse rates at a median follow-up of more than 5 years were similar in both groups.
ㅤ A prospective, multicenter, randomised trial
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Study participants:
625 patients with histologically confirmed stage I testicular seminoma (pT1-3 tumors)
with normal post-orchidectomy alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG).
Increased pre-orchidectomy serum AFP and T4 disease (margin positive at the cut end of the spermatic cord) rendered a patient ineligible.
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Key study outcomes:
The 30- and 20-Gy groups reported 10 and 11 relapses, respectively, with a median follow-up of 61 months (hazard ratio, 1.11; 90% CI, 0.54 to 2.28).
The absolute difference in 2-year relapse rates was 0.7%.
With the median follow-up of more than 5 years, TE18 allowed reliable exclusion of an absolute increase in relapse rates of more than 3% when treated with a 20Gy protocol, and cancer-specific survival exceeded 99% in the 20Gy cohort.
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Study Limitations:
The number of relapses was small and caution must be applied when drawing conclusions.
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