Testicular cancer medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Shanshan Cen, M.D. [3]

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Overview

The predominant therapy for testicular cancer is surgical resection. Adjunctive chemotherapy and radiation therapy may be required.

Medical Therapy

Germ cell tumors

Seminoma:

Seminoma is sensitive to radiotherapy and chemotherapy.

Stage IA and IB[1]

Stage IS

Stage IIA

Stage IIB or IIC

Radiation therapy

Chemotherapy

Standard-dose chemotherapy[8][9]

  • The most common chemotherapy combinations used to treat testicular cancer are:
  • It is usually given IV every 3 weeks for 3 months for 3 cycles for metastasis to brain, stage IIA, IIB, IIC, and good risk stage III seminoma as well as good risk stage IIA, IIB, and stage IIC, IIIA Nonseminoma.
  • It is used when bleomycin affects the lungs or there is a high risk that it will cause lung damage.
  • If testicular cancer does not respond to the above drugs or if it recurs, the following chemotherapy combinations may be used. These are sometimes called salvage, or second-line, chemotherapy.
  • It is given IV every 3 weeks for 3 months, or 4 cycles.
  • It is given IV every 3 weeks for 3 months, or 4 cycles.
  • It is given IV every 3 weeks for 3 months, or 4 cycles.

High-dose chemotherapy

Palliative chemotherapy

Sex cord stromal testicular tumors

References

  1. Oliver, T.; Dieckmann, K.-P.; Steiner, H.; Skoneczna, I. (2005). "Pooled analysis of phase 2 reports of 2 v 1 course of carboplatin as adjuvant for stage 1 seminoma". Journal of Clinical Oncology. 23 (16_suppl): 4572–4572. doi:10.1200/jco.2005.23.16_suppl.4572. ISSN 0732-183X.
  2. Chovanec M, Hanna N, Cary KC, Einhorn L, Albany C (November 2016). "Management of stage I testicular germ cell tumours". Nat Rev Urol. 13 (11): 663–673. doi:10.1038/nrurol.2016.164. PMID 27618772.
  3. "NCCN Clinical Practice Guidelines in Oncology: Testicular cancer. National comprehensive cancer network, 2019; https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf."
  4. Wilder RB, Buyyounouski MK, Efstathiou JA, Beard CJ (July 2012). "Radiotherapy treatment planning for testicular seminoma". Int. J. Radiat. Oncol. Biol. Phys. 83 (4): e445–52. doi:10.1016/j.ijrobp.2012.01.044. PMID 22436787.
  5. "NCCN Clinical Practice Guidelines in Oncology: Testicular cancer. National comprehensive cancer network, 2019; https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf."
  6. "NCCN Clinical Practice Guidelines in Oncology: Testicular cancer. National comprehensive cancer network, 2019; https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf."
  7. Classen J, Schmidberger H, Meisner C, Souchon R, Sautter-Bihl ML, Sauer R, Weinknecht S, Köhrmann KU, Bamberg M (March 2003). "Radiotherapy for stages IIA/B testicular seminoma: final report of a prospective multicenter clinical trial". J. Clin. Oncol. 21 (6): 1101–6. doi:10.1200/JCO.2003.06.065. PMID 12637477.
  8. "International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group". J. Clin. Oncol. 15 (2): 594–603. February 1997. doi:10.1200/JCO.1997.15.2.594. PMID 9053482.
  9. Garcia-del-Muro X, Maroto P, Gumà J, Sastre J, López Brea M, Arranz JA, Lainez N, Soto de Prado D, Aparicio J, Piulats JM, Pérez X, Germá-Lluch JR (November 2008). "Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ Cell Cancer Group Study". J. Clin. Oncol. 26 (33): 5416–21. doi:10.1200/JCO.2007.15.9103. PMID 18936476.
  10. Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB, Donohue JP, Paulson DF, Brunner KW, Jacobs EM, Spaulding JT (December 1987). "Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer". N. Engl. J. Med. 317 (23): 1433–8. doi:10.1056/NEJM198712033172303. PMID 2446132.
  11. Kollmannsberger C, Moore C, Chi KN, Murray N, Daneshmand S, Gleave M, Hayes-Lattin B, Nichols CR (June 2010). "Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy". Ann. Oncol. 21 (6): 1296–301. doi:10.1093/annonc/mdp473. PMID 19875756.
  12. Conkey DS, Howard GC, Grigor KM, McLaren DB, Kerr GR (August 2005). "Testicular sex cord-stromal tumours: the Edinburgh experience 1988-2002, and a review of the literature". Clin Oncol (R Coll Radiol). 17 (5): 322–7. PMID 16097561.
  13. Farkas LM, Székely JG, Pusztai C, Baki M (August 2000). "High frequency of metastatic Leydig cell testicular tumours". Oncology. 59 (2): 118–21. doi:10.1159/000012147. PMID 10971169.

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