Sandwich therapy in testis tumor: current experience

Sandwich therapy, a regimen of lymphadenectomy combined with preoperative and postoperative cobalt teletherapy, yielded a survival rate of 84% in 13 patients with stages A and B non-seminomatous testis tumor. This statistic is consistent with the previously reported survival rate of 83% achieved among 35 patients treated with this regimen from 1958 to 1970 at our institution. Bone marrow depression, retroperitoneal fibrosis and possible induction of a second malignancy were important side effects of radiation therapy. The superior survival rates with fewer severe side effects of treatment obtained by other investigators using either lymphadenectomy alone or lymphadenectomy combined with chemotherapy have prompted us to discontinue sandwich therapy as standard treatment for non-seminomatous testis tumors at our institution.