A retrospective study of all cases of seminoma treated at Roswell Park Memorial Institute from 1970 through 1979 was conducted. Fifty-six evaluable patients treated initially with radiation therapy were seen during this period, and the overall survival rate at an average follow-up period of 52 months was 82%. The survival rate in patients with bulky abdominal or supradiaphragmatic metastases was only 33% (4 of 12 patients). Treatment failures were analyzed to determine their apparent causes and the implication of such failures to the future management of seminoma. The use of combination chemotherapy as the initial treatment modality in advanced seminoma is discussed in light of these results.
Cuncer 5 3 ~4 5 1 -1 4 5 5 , 1984.
LTHOUGH RADIATION THERAPY is of unquestionable
A value in the treatment of early stages of seminoma of the testis, the current cure rates for patients with advanced bulky abdominal or supradiaphragmatic seminoma treated with conventional radiation therapy is considered, by some, to be unacceptable.' The management of advanced seminoma remains controversial and radiation therapy continues to be the recommended form of therapy regardless of stage of In this retrospective review, initial radiation therapy and subsequent treatment modalities were ana1yzi:d to determine the likelihood of response to the various forms of treatment employed, with particular attention to those patients who were treatment failures.
Materials and Methods
A review of the records for the 1 0-year period at Roswell Park Memorial Institute, 1970 to 1979, disclosed a total of 62 patients who were seen wilh the diagnosis of pure seminoma of the testis. Three patients were lost to followup. and one patient, who had previously refused treatment, was admitted in a preterminal state and was excluded from further analysis. Two patients were treated initially with chemotherapy for advanced seminoma, and were excluded from further analysis, so that subsequent