RADIATION-INDUCED TUMORS IN IRRADIATED STAGE-I TESTICULAR SEMINOMA - RESULTS OF A 25-YEAR FOLLOW-UP (1968-1993)

Background and Objectives: Testicular seminoma is a very radiosensitiv e and curable cancer, with survival rates following radiation therapy within the range of 90-98% without apparent severe side effects. Howev er, long-term survival following exposure to moderate-dose radiation t herapy can result in radiation-induced tumors. Methods: The incidence of radiation-induced tumors was determined in 81 irradiated stage I te sticular seminoma patients treated at the Northern Israel Oncology Cen ter (NIOC) from 1968 through 1993. Results: Three (4%) patients develo ped second cancers within the high-dose volume. Indeed, those patients received a higher than usual dose to the para-aortic and pelvic regio ns. One patient, who developed inoperable pancreatic carcinoma, was tr eated with ''hockey stick'' field and mediastinal irradiation, plus, a s a result of relapses, multiple cisplatin and VP-16 based regimens. C onclusions: The elimination of causative factors through lower total d oses and field size reduction may reduce the, albeit very low, inciden ce of radiation-induced cancer in cured testicular seminoma. (C) 1998 Wiley-Liss, Inc.