Therapy of clinical stage IIA and IIB seminoma: a systematic review - Summary - MDSpire

Therapy of clinical stage IIA and IIB seminoma: a systematic review

  • By

  • Julia Heinzelbecker

  • Stefanie Schmidt

  • Julia Lackner

  • Jonas Busch

  • Carsten Bokemeyer

  • Johannes Classen

  • Annette Dieing

  • Oliver Hakenberg

  • Susanne Krege

  • Alexandros Papachristofilou

  • David Pfister

  • Christian Ruf

  • Hans Schmelz

  • Heinz Schmidberger

  • Rainer Souchon

  • Christian Winter

  • Friedemann Zengerling

  • Sabine Kliesch

  • Peter Albers

  • Christoph Oing

  • November 15, 2021

  • 0 min

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Objective:

To summarize the available evidence regarding the different treatment modalities for clinical stage IIA/B seminoma, defined by disease spread to retroperitoneal lymph nodes, and their associated acute and long-term toxicities.

Key Findings:
  • Seven comparative studies met inclusion criteria, involving 5049 patients, providing a robust dataset for analysis.
  • Overall relapse rates (RR) for radiotherapy (RT) were 10.2% and 24.2%; for chemotherapy (CT), RR was 0%, indicating a significant difference in treatment efficacy.
  • Five-year overall survival (OS) rates were 82% for RT and 88% for CT; cancer-specific survival (CSS) rates were 100% for both treatments, highlighting the effectiveness of both modalities.
  • Acute toxicities included nausea (92% grade 1/2) and diarrhea (51% grade 1/2) in RT patients; CT patients experienced higher rates of grade 3/4 neutropenia (22%), suggesting a need for careful monitoring.
Interpretation:

RT shows lower relapse rates and better survival outcomes compared to CT for CS IIA/B seminoma, with significant acute and late toxicities associated with CT, which should be considered in treatment planning.

Limitations:
  • Studies varied in reporting treatment specifics and outcomes, leading to potential biases that may affect the reliability of the findings.
  • Only two studies assessed toxicities comprehensively, limiting the understanding of long-term effects.
Conclusion:

RT is preferred for treating CS IIA/B seminoma due to better survival outcomes and lower relapse rates compared to CT, despite associated toxicities that warrant consideration in treatment decisions.

Original Source(s)

Therapy of clinical stage IIA and IIB seminoma: a systematic review

  • by Julia Heinzelbecker, Stefanie Schmidt, Julia Lackner, Jonas Busch, Carsten Bokemeyer, Johannes Classen, Annette Dieing, Oliver Hakenberg, Susanne Krege, Alexandros Papachristofilou, David Pfister, Christian Ruf, Hans Schmelz, Heinz Schmidberger, Rainer Souchon, Christian Winter, Friedemann Zengerling, Sabine Kliesch, Peter Albers, Christoph Oing

  • November 15, 2021

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