Radiation therapy of seminoma of the testis

This study is a review of 66 patients with a diagnosis of testicular seminoma, treated at the Department of Radiation Oncology, University of Louisville, from 1959 to 1978. Sixty-four of the patients were diagnosed as pure seminomas and two as spermatocytic type. The age of the patients ranged from 16 to 75 years with a median of 39. Fifty-four patients (82%) presented with swelling or mass in the testis, 7 patients with pain, 1 patient with hydrocele, and 4 patients had seminoma diagnosed incidentally. The distribution was equal for both right and left sides. There were 39 (59%) and 27 (41%) patients in stages I and II, respectively. All stage I patients received only infradiaphragmatic irradiation by a "hockey stick" field, and the majority of them received a dose of 3,200-3,600 rads in 3-4 weeks time. Stage II patients received elective irradiation to the mediastinum and neck region, in addition to the infradiaphragmatic irradiation. The 5-year actuarial survival rates for stage I and II seminomas are 96% and 92%, respectively. There were no serious complications during follow-up. The role of elective irradiation in stage I disease is discussed with a brief review of the literature.