Long-term evaluation of postorchiectomy irradiation for stage I seminoma.

Purpose: To determine the late clinical effects of irradiation in stage I seminoma.

Materials And Methods: From 1966 to 1991, 104 patients with stage I seminoma were treated and followed up. After inguinal orchiectomy, all underwent megavoltage infradiaphragmatic irradiation through a "hockey stick" field encompassing the periaortic and ipsilateral iliac lymph nodes (30 Gy in 1.5-Gy fractions).

Results: There were no serious, acute toxic effects or late complications. Three patients developed tumor recurrence at 9, 10, and 17 months; two had no evident disease 5 and 25 years after salvage chemotherapy and radiation therapy. Six patients developed second malignancies a mean of 10 years after treatment. None were considered to be radiation induced, and five of these patients had no evident disease after appropriate treatment.

Conclusion: The first course of postorchiectomy irradiation controls stage I seminoma in most patients (101 of 104 [97.1%]) and causes no serious, acute toxic effects or late complications.