Radiotherapy for pure seminoma of the testis

Testicular tumors initially diagnosed as pure seminoma were irradiated following orchiectomy in 141 patients. Analysis of treatment failures reveals that (a) 2500 rads is adequate for elective irradiation and 3500 rads for small to moderate-size metastases; (b) elective irradiation of the mediastinum and left supraclavicular area is not indicated for Stage I, but is for Stage II; (c) patient with bulky retroperitoneal disease should be treated initially through total abdominal portais followed by additional treatment through reduced fields; and (d) presence of embryonal carcinoma, teratocarcinoma, or choricarconoma should be considered when regression is poor.