Early Stage II Testicular Cancer: Radiotherapy more better than Chemotherapy?

A large study on testicular cancer shows early stage for those simplified testicular seminoma patients with stage II cells, the therapeutic effect of radiotherapy is superior to chemotherapy. Early stage II testicular cancer that has not yet appeared distant metastases, but may have more than one lymph node involvement and tumor size should be smaller than 50px early testicular cancer

The results published in the Journal of Clinical Oncology. Prior to that, there is little evidence to tell us what kind of treatment is more effective against testicular cancer. But people seem to be more inclined to use the way chemotherapy treatment for testicular tumors.

The study contains a total of 2437 patients with stage II testicular cancer, is by far the largest of testicular cancer research II. The researchers found that, IIa of testicular cancer patients receiving radiation therapy after 5-year survival was 99%, while the 5-year survival rate after chemotherapy was 93%. Testicular cancer patients for Phase IIb, the 5-year survival after radiotherapy was 95%, while the 5-year survival after chemotherapy was 92%.

Dr. Scott Glaser University of Pittsburgh Cancer Institute, said: “testicular cancer is a rare disease, the current lack of random data can be used to guide therapy, previous studies also have problems because of the number of samples there are many restrictive therefore, us. before chemotherapy and radiotherapy is difficult to tease out the minor differences in patients and physicians prefer to reason chemotherapy, radiotherapy probably stems from a misunderstanding of the toxicity that the radiation on the body will be greater than the damage caused by chemotherapy 3-4 cycles. according to the results of this study the researchers found, radiotherapy for testicular cancer patients IIa of better treatment, treatment for testicular cancer patients in phase IIb as much as chemotherapy. ”

Analysis of the 2437 data in patients with stage II testicular cancer, they were diagnosed in 1998 to 2012 with testicular cancer and underwent radiation therapy or chemotherapy. Among them, 960 are in phase IIa of testicular cancer patients, 78% received radiotherapy, 22% received chemotherapy; 812 in testicular cancer patients Phase IIb in 54% received radiotherapy, 46% received chemotherapy; 665 in IIc of testicular cancer patients and 4% received radiotherapy, 96% received chemotherapy.

For research data IIc patients, Dr. Glaser analysis to: “For IIc of testicular cancer patients, clinicians have reached a consensus that chemotherapy is the preferred treatment for testicular cancer patients IIc of the trial, IIc of testicular cancer. 96% of patients receiving chemotherapy, the proportion of severely limits treatment than the meaning. ”

At the same time, he believes that the results of this study support the radiation therapy recommended as the preferred treatment for patients with testicular cancer phase IIa. “We IIb regarded as diversion of the transitional phase, some patients (tumor diameter 2-75px) will be more inclined to IIa of testicular cancer can be better positioned to benefit from a radiotherapy; also some patients (tumor diameter is 4- there are more than 125px or lymph node involvement) more inclined to IIc of testicular cancer, benefit from chemotherapy will be more. “Dr. Glaser concluded,” our study at least shows the need for an open phase IIa-b randomized trial of patients with testicular cancer radiotherapy and chemotherapy to explore the respective roles. ”

Limiting research mainly in the shorter follow-up time, a retrospective study itself and the researchers did not describe the treatment of the disease control to what extent or how much to reduce death rates.

Philip Poortmans professor was not involved in the trial, he concluded that: “the lack of prospective randomized trials for some rare diseases, such as stage II testicular seminoma, for patients in real life data analysis will help us confirm those used to guide treatment the recommendation is valid patients tend to abandon radiotherapy and chemotherapy is generally the reason for the toxicity of radiotherapy fear now, I am afraid that this bias is not correct: higher overall survival after radiotherapy, but most received. Ideally, these conclusions can be demonstrated by a prospective randomized trial, and require long-term follow-up of the side effects of a comprehensive analysis. However, this study estimated that difficult. “