The treatment of supradiaphragmatic metastatic seminoma

Forty-four patients with supradiaphragmatic metastases from seminoma of the testis treated between 1960 and 1973 were studied. Nine patients had metastases at presentation, the remainder developed following abdominal irradiation. Only six patients were long-term survivors, five having nodal disease and one pulmonary parenchymal involvment. Thirty-three patients were treated by whole lung irradiation. The complete remission rate in these cases was poor (55%) despite the use of a dose which gave an appreciable incidence of pulmonary radiation damage. The results are in contrast to the excellent response to treatment obtained with subdiaphragmatic disease.