Testicular Cancer

Part of the Medical Radiology book series (MEDRAD)


Testicular cancer is a common malignancy of young men, and almost always of germ cell origin. Radiotherapy has an important role in the management of seminoma, whereas non-seminoma is typically managed by surgery and chemotherapy. Stage I seminoma may be managed by surveillance, adjuvant radiotherapy or chemotherapy. The clinical target volume includes the para-aortic nodes and usually the ipsilateral common and proximal external iliac nodes. Renal hilar nodes are included for left-sided tumors. No follow-up pelvic imaging is required if the upper pelvic lymph nodes are included in the treatment volume, whereas ongoing CT surveillance of the pelvis is required if treatment is limited to the para-aortic region alone. Radiation dose ranges from 20 Gy in 10 fractions to 25 Gy in 20 fractions. Relapse-free survival is 95-97%, and cause-specific survival close to 100%. Stage II seminoma with nodal disease < 5 cm, is also managed by para-aortic and ipsilateral pelvic nodal irradiation. A further 8-10 Gy boost is commonly given to gross disease > 4 cm, resulting in disease-free survival of 85-92%. Patients with stage I disease who relapse on surveillance are managed in the same fashion. Bulkier stage II or stage III disease is best managed with cisplatin-based combination chemotherapy, again resulting in a long-term disease-specific survival of > 90%.


Planning Target Volume Germ Cell Tumor Testicular Cancer Clinical Target Volume Spermatic Cord 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Radiation Oncologist, Sunnybrook Odette Cancer CentreUniversity of TorontoTorontoCanada
  2. 2.Department of Radiation OncologyUniversity of Auckland Medical SchoolAucklandNew Zealand

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