Testicular seminoma--analysis of radiation therapy for stage II disease

Controversy exists regarding the extent of radiation to be delivered in patients with stage IIA testicular seminoma. We analyzed patients treated at our hospital radiation center through February 1981 in an attempt to evaluate the contribution of supradiaphragmatic radiation therapy in this disease. Six patients with stage IIA disease were not treated above the diaphragm and none failed, while 50 with stage I tumor in whom no lymphangiogram or computerized tomography scan was performed were treated below the diaphragm and none failed in the mediastinum or supraclavicular area. We agree with other investigators that radiation therapy above the diaphragm in patients with stage IIA testicular seminoma may be unnecessary.