
Between 1976 and 1981, 63 patients with Stage II-IV testicular non-seminoma were treated by chemotherapy followed 4-6 weeks later by involved field radiotherapy. Of this group, 58 (92.1%) are alive and tumour-free, one patient died post-operatively and four of uncontrolled disease. There were no deaths from drug-induced neutropenic sepsis. During the same period a second group of 53 patients who had received radiotherapy were given chemotherapy for recurrent disease. Of this group, 38 (71.7%) are alive and tumour-free, eight died of uncontrolled malignancy, six from drug-related complications and one from a myocardial infarct. In patients receiving elective post-chemotherapy irradiation, tumour volume exerted little influence on treatment outcome, the disease-free survival rates for small volume and bulky disease being 100% and 87.2%, respectively. Conversely, in patients receiving chemotherapy after prior irradiation there was a significant difference; 96.7% and 43.4%, respectively (p less than 0.001). Of the 63 patients in the drug-irradiation protocol group 23 (36.5%) had residual masses excised. In 18 patients (78.2%) the excised tissue showed either fibrosis or mature teratoma. Despite the excellent survival figures for patients receiving post-chemotherapy irradiation the value of this approach cannot be assumed, although the slight difference between small and bulky presentations suggests that radiotherapy may have contributed to the therapeutic result.
Male, Testicular Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Humans, Neoplasm Recurrence, Local, Combined Modality Therapy
Male, Testicular Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Humans, Neoplasm Recurrence, Local, Combined Modality Therapy
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