Seminoma
Current Clinical Trials
Note: Some citations in the text of this section are followed by a level of
evidence. The PDQ editorial boards use a formal ranking system to help the
reader judge the strength of evidence linked to the reported results of a
therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more
information.)
The diagnosis of seminoma requires that the serum alpha fetoprotein (AFP) be
normal, and no other germ cells be present. Management decisions in patients presenting with these tumors can sometimes be difficult.
As in testicular seminoma, these tumors
are very radiosensitive. About 60% to 80% of patients will remain disease free after
treatment with radiation therapy.[1] Craniospinal radiation therapy for intracranial germinomas (the
intracranial counterpart of seminoma) is associated with relapse-free and
overall survival rates of 90% to 95% at 5 years as evidenced in the MAKEI-83/86/89 trial, for example.[2][Level of evidence: 3iiiA]
Initial chemotherapy with regimens used in nonseminoma testicular cancer is also
very efficacious. Practically speaking, patients with localized relatively
small tumors are usually treated initially with radiation, while those with
very bulky tumors or nonlocalized tumors are treated with etoposide-based and
cisplatin-based chemotherapy regimens.
As in testicular seminoma, many patients will be left with a residual mass posttreatment. If the residual mass is smaller than 3.0 cm,
the majority of experts agree that observation is appropriate. In those with larger residual
masses, some experts favor surgical excision while others favor
observation.[3,4]
Current Clinical Trials
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with extragonadal seminoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
References
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Clamon GH: Management of primary mediastinal seminoma. Chest 83 (2): 263-7, 1983.
[PUBMED Abstract]
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Bamberg M, Kortmann RD, Calaminus G, et al.: Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89. J Clin Oncol 17 (8): 2585-92, 1999.
[PUBMED Abstract]
-
Motzer R, Bosl G, Heelan R, et al.: Residual mass: an indication for further therapy in patients with advanced seminoma following systemic chemotherapy. J Clin Oncol 5 (7): 1064-70, 1987.
[PUBMED Abstract]
-
Schultz SM, Einhorn LH, Conces DJ Jr, et al.: Management of postchemotherapy residual mass in patients with advanced seminoma: Indiana University experience. J Clin Oncol 7 (10): 1497-503, 1989.
[PUBMED Abstract]
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