Testicular seminoma--the results of treatment by radiotherapy in Singapore.

A retrospective analysis was done of 49 patients treated for testicular seminoma over a 15-year period between January 1980 and April 1995 at the Department of Therapeutic Radiology, Singapore General Hospital. Their mean age was 39 years and their median period of follow-up was 67 months. Using the Royal Marsden Staging classification, 35 (71.4%) were stage I, 10 (20.4%) were stage II, I (2%) was stage III, and 3 (6.1%) were stage IV. Five (10.2%) arose in undescended testes. Thirty-six patients were treated with inguinal orchidectomy and postoperative radiotherapy to the para-aortic and ipsilateral iliac nodes. Eight had para-aortic and bilateral iliac irradiation, and 2 had ipsilateral pelvic, para-aortic, mediastinal and supraclavicular lymph node irradiation. Six of the patients had, in addition, irradiation of the inguinal-scrotal area. Nine received both chemotherapy as well as radiotherapy. The median dose of radiation given was 30.67 Gy and where a boost was required, the median total tumour dose was 35.75 Gy. The actuarial relapse-free survival at 10 years was 88.9% and the actuarial overall survival at 10 years was also 88.9%. Long-term treatment toxicities were uncommon.