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Technical Basis of Radiation Therapy pp 1027–1040Cite as

Testicular Cancer

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Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

Testicular cancer is a common malignancy of young men, and almost always of germ cell origin. Radiotherapy has an important role in the management of seminoma, whereas non-seminoma is typically managed by surgery and chemotherapy. Stage I seminoma may be managed by surveillance, adjuvant radiotherapy or chemotherapy. The clinical target volume includes the para-aortic nodes and usually the ipsilateral common and proximal external iliac nodes. Renal hilar nodes are included for left-sided tumors. No follow-up pelvic imaging is required if the upper pelvic lymph nodes are included in the treatment volume, whereas ongoing CT surveillance of the pelvis is required if treatment is limited to the para-aortic region alone. Radiation dose ranges from 20 Gy in 10 fractions to 25 Gy in 20 fractions. Relapse-free survival is 95-97%, and cause-specific survival close to 100%. Stage II seminoma with nodal disease < 5 cm, is also managed by para-aortic and ipsilateral pelvic nodal irradiation. A further 8-10 Gy boost is commonly given to gross disease > 4 cm, resulting in disease-free survival of 85-92%. Patients with stage I disease who relapse on surveillance are managed in the same fashion. Bulkier stage II or stage III disease is best managed with cisplatin-based combination chemotherapy, again resulting in a long-term disease-specific survival of > 90%.

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Authors and Affiliations

  1. Radiation Oncologist, Sunnybrook Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

    Gerard C. Morton & Maria Pearse

  2. Department of Radiation Oncology, University of Auckland Medical School, Auckland, New Zealand

    Maria Pearse

Authors
  1. Gerard C. Morton
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  2. Maria Pearse
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Correspondence to Gerard C. Morton .

Editor information

Editors and Affiliations

  1. Institutet Stockholm Sweden, MMC 436, Dept.of Oncol-Pathol Karolinska, Delaware St. SE 420, Minneapolis, 55455, Minnesota, USA

    Seymour H. Levitt

  2. UC Davis Cancer Center, Dept. Radiation Oncology, University of California, Davis, X Street 4501, Sacramento, 95817, California, USA

    James A. Purdy

  3. School of Medicine, Dept. Radiation Oncology, Washington University, Forest Park Ave. 4511, St. Louis, 63108-2138, Michigan, USA

    Carlos A. Perez

  4. Instituut Verbeeten, Tilburg, 5042 SB, Netherlands

    Philip Poortmans

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© 2011 Springer-Verlag Berlin Heidelberg

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Morton, G.C., Pearse, M. (2011). Testicular Cancer. In: Levitt, S., Purdy, J., Perez, C., Poortmans, P. (eds) Technical Basis of Radiation Therapy. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_329

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  • DOI: https://doi.org/10.1007/174_2011_329

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-11571-4

  • Online ISBN: 978-3-642-11572-1

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