Radiation therapy for testicular tumors metastasizing to the lungs

Records of 63 cases of testicular tumors treated at the Hunter Radiation Therapy Center, Yale-New Haven Hospital from 1962 through 1971 were reviewed. One hundred percent cure rate was obtained in the 36 Stage I and II pure seminoma (Group I) patients. For Stage I, the para-aortic and homolateral iliac lymph nodes were irradiated to a dose of 3,000 to 3,500 rads in three to four weeks. Elective irradiation of the mediastinum and supraclavicular areas was omitted. For Stage II, such extended field irradiation was employed to a dose of 2,000 to 3,000 rads in two to three weeks. Six (or 43 percent) of the 14 embryonal carcinoma (Group II) patients are alive for a minimum of three to a maximum of eleven years. Both teratoma (Group III) patients are alive at five and seven years as well. All eight Stage I teratocarconoma (Group IV) patients are alive with no evident disease at three to ten years. Our data indicate the difference in prognosis between patients who subsequently developed localized lung metastases and those who initially presented with pulmonary disease. We conclude that intensive combined efforts of both radiation and medical oncologists can salvage a considerable number of patients with metachronous onset of pulmonary metastases.