Therapie des Hoden-Karzinomss
Allgemeines
Therapie: Seminom
| Stadium | Behandlung | 5a-OS | Bemerkungen |
| I | Verlaufsbeobachung | >99% | (11, 12, 13) |
| Bestrahlung 20Gy | |||
| Carboplatin 1-2x | |||
| II | 30-36Gy (LK <3cm) | >95% | (13) |
| 3x BEP (LK ab 3cm) | |||
| 4x EP (LK ab 3cm) | |||
| III | 3x BEP | >90% | (18, 20) |
| 4x EP |
Therapie: Non - Seminom
| Stadium | Behandlung | 5a-OS | Bemerkungen |
| I | Verlaufsbeobachung | >99% | (14, 16) |
| retroperitoneale Lymphonodektomie | |||
| BEP 1x | |||
| II | retroperitoneale Lymphonodektomie (LK <3cm) | 98% | (15, 17) |
| 3x BEP (LK ab 3cm) | |||
| 4x EP (LK ab 3cm) | |||
| III, good risk | 3x BEP | >90% | (18, 19, 20, 21) |
| 4x EP | |||
| III, intermediate-, poor risk | 4x 3-fach-Kombination | 50-80% | (22, 23) |
Operation
kontralateraler Hoden
Radiatio
Chemotherapie
offene Protokolle
Ergebnisse
EORTC 30942 (9)
MRC/EORTC-Trial: RT v Carboplatin(10)
Quellen
Guidelines on Testicular Cancer.
European Association of Urology 2009
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Prevalence of contralatral testicular intraepithelial neoplasia in patients with testicular germ cell neoplasms.
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3.) Von der Maase H, et al.:
Carcinoma-in-situ of contralateral testis in patients with testicular germ cell cancer: study of 27 cases in 500 patients.
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Intratubular germ cell neoplasia of contralateral testis in testicular cancer: defining a high risk group.
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5.) Tabernero J, et al.:
Incidence of contralateral germ cell testicular tumours in South Europe: report of the experience at 2 Spanish university hospitals and review of the literature.
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6.) Herr HW, Sheinfeld J:
Is biopsy of the contralateral testis necessary in patients with germ cell tumors?
J Urol 158(1997):1331-4
7.) Classen J, et al.:
German Testicular Cancer Study Group. Radiotherapy with 16 Gy may fail to eradicate testicular intraepithelial neoplasia: preliminary communication of a dose-reduction trial of the German Testicular Cancer Study Group.
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Impact of cytotoxic treatment on long-term fertility in patients with germ-cell cancer.
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9.) Jones WG, Fossa SD, Mead GM, et al.:
Randomized trial of 30 versus 20 Gy in the adjuvant treatment of stage I testicular seminoma: a report on Medical Research Council Trial TE18, European Organisation for the Research and Treatment of Cancer Trial 30942 (ISRCTN18525328).
J Clin Oncol 23(2005):1200–1208
10.) Oliver RT, Mason MD, Mead GM, et al.:
Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial.
Lancet 366(2005):293–300
11.) Oliver RT, Mead GM, Rustin GJ, et al:
Randomized trial of carboplatin versus radiotherapy for stage I seminoma: Mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (IS-RCTN27163214).
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12.) Mortensen MS, Gundgaard MG, Lauritsen J, et al:
A nationwide cohort study of surveillance for stage I seminoma.
J Clin Oncol 31(2013):284s, suppl, abstr 4502
13.) Schmoll HJ, Jordan K, Huddart R, et al:
Testicular seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
Ann Oncol: 21(2010): v140–v146, suppl 5
14.) Kollmannsberger C, Tandstad T, Bedard P, et al:
Characterization of relapse in patients with clinical stage I (CSI) nonseminoma (NS-TC) managed with active surveillance (AS): A large multicenter study.
J Clin Oncol 31(2013):284s, abstr 4503
15.) Schmoll HJ, Jordan K, Huddart R, et al:
Testicular non-seminoma: ESMO clinical recommendations for diagnosis, treatment and follow-up.
Ann Oncol 20(2009):89-96, suppl 4
16.) Albers P, Siener R, Krege S, et al:
Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I Nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group.
J Clin Oncol 26(2008):2966-2972
17.) Donohue JP, Thornhill JA, Foster RS, et al:
The role of retroperitoneal lymphadenectomy in clinical stage B testis cancer: The Indiana University experience (1965 to 1989).
J Urol 153(1995):85-89
18.) Bosl GJ, Geller NL, Bajorin D, et al:
A randomized trial of etoposide + cisplatin versus vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin in patients with good-prognosis germ cell tumors.
J Clin Oncol 6(1988):1231-1238
19.) Williams SD, Birch R, Einhorn LH, et al:
Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide.
N Engl J Med 316(1987):1435-1440
20.) Einhorn LH, Williams SD, Loehrer PJ, et al:
Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: A Southeastern Cancer Study Group protocol.
J Clin Oncol 7(1989):387-391
21.) Culine S, Kerbrat P, Kramar A, et al:
Refining the optimal chemotherapy regimen for good-risk metastatic nonseminomatous germ-cell tumors: A randomized trial of the Genito-Urinary Group of the French Federation of Cancer Centers (GETUG T93BP).
Ann Oncol 18(2007):917-924
22.) Nichols CR, Catalano PJ, Crawford ED, et al:
Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: An Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study
J Clin Oncol 16(1998):1287-1293
23.) Motzer RJ, Nichols CJ, Margolin KA, et al:
Phase III randomized trial of conventional-dose chemotherapy with or without high-dose chemotherapy and autologous hematopoietic stem-cell rescue as first-line treatment for patients with poor-prognosis metastatic germ cell tumors.
J Clin Oncol 25(2007):247-256
