Seminoma medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

Overview

Treatments of patients with seminoma depends on stage of seminoma, risk of recurrence, Fertility and Preferences of the individual. The majority of patients with seminoma are treated Chemotherapy. Chemotherapy is helpful for all stages of seminoma. Chemotherapy is used in patients who have done orchiectomy. A combination of chemotherapy drugs is usually given. Seminoma is a radiosensitive tumor. Radiation therapy may be helpful to treat stage I or II seminomas after orchiectomy. Active surveillance is the preferred treatment for stege I seminoma after a radical inguinal orchiectomy. There are no standard active surveillance schedules for seminoma. There are no standard active surveillance schedules for seminoma.

Treatment of Seminoma

Stage I

Stage II

Stage III

Recurrent

❑ Surgery
❑ Active surveillance
❑ Radiotherapy
❑ Chemotherapy

Chemotherapy is a common treatment for all stages of seminoma. It is usually given after an orchiectomy. A combination of chemotherapy drugs is usually given.
BEP is the main chemotherapy combination used for seminoma. It includes bleomycin, etoposide, and cisplatin.
Sometimes, physicians just give etoposide and cisplatin (called EP). EP is given when bleomycin affects the lungs (called pulmonary toxicity), or there is a high risk that it will cause lung damage.
High-dose chemotherapy and stem cell transplant may be used for recurrent testicular cancer, if the standard-dose chemotherapy doesn’t work and the cancer comes back.
High doses of carboplatin and etoposide are given. After high-dose chemotherapy, a stem cell transplant is done to replace the stem cells that are damaged or destroyed by high-dose chemotherapy. The stem cell transplant is an autologous peripheral blood stem cell transplant.

Seminoma is a radiosensitive tumor (vs. nonseminomatous germ cell tumors)
Radiation therapy may be used to treat stage I or II seminomas after orchiectomy.
It is given as external beam radiation therapy.
Radiation is directed at the lymph nodes in the abdomen and pelvis.

Active surveillance is the preferred treatment for stage I seminoma after a radical inguinal orchiectomy.
During active surveillance, the healthcare team watches for any signs and symptoms of recurrence. Treatment is given only if seminoma recurs.
There are no standard active surveillance schedules for seminoma. Active surveillance may last for 5-10 years. You may have follow-up visits every 2-6 months for the first 3 years.

↑ Cullen, M. (2012). “Surveillance or adjuvant treatments in stage 1 testis germ-cell tumours”. Annals of Oncology. 23 (suppl 10): x342–x348. doi:10.1093/annonc/mds306. ISSN 0923-7534.
↑ Sagalowsky AI (October 2000). “Treatment options for clinical stage 1 testis cancer”. Proc (Bayl Univ Med Cent). 13 (4): 372–5. PMC 1312235. PMID 16389345.
↑ Boujelbene N, Cosinschi A, Boujelbene N, Khanfir K, Bhagwati S, Herrmann E, Mirimanoff RO, Ozsahin M, Zouhair A (August 2011). “Pure seminoma: a review and update”. Radiat Oncol. 6: 90. doi:10.1186/1748-717X-6-90. PMC 3163197. PMID 21819630.
↑ Ahmed KA, Wilder RB (2015). “Stage IIA and IIB testicular seminoma treated postorchiectomy with radiation therapy versus other approaches: a population-based analysis of 241 patients”. Int Braz J Urol. 41 (1): 78–85. doi:10.1590/S1677-5538.IBJU.2015.01.11. PMC 4752059. PMID 25928512.
↑ Lieng H, Warde P, Bedard P, Hamilton RJ, Hansen AR, Jewett M, O’malley M, Sweet J, Chung P (February 2018). “Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach”. Can Urol Assoc J. 12 (2): 59–66. doi:10.5489/cuaj.4531. PMC 5937398. PMID 29381453. Vancouver style error: initials (help)
↑ Lodi D, Iannitti T, Palmieri B (January 2011). “Stem cells in clinical practice: applications and warnings”. J. Exp. Clin. Cancer Res. 30: 9. doi:10.1186/1756-9966-30-9. PMC 3033847. PMID 21241480.