Testicular cancer medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
Stage IA and IB | Stage IA and IB | ||
*Surveillance for pT1-T3 tumors or | *Surveillance for pT1-T3 tumors or | ||
*Single agent carboplatin for 1 or 2 cycles followed with chest X-ray and CT scan of the abdomen and pelvis | *Single agent carboplatin for 1 or 2 cycles followed with chest X-ray and CT scan of the abdomen and pelvis <ref name="pmid27618772">{{cite journal |vauthors=Chovanec M, Hanna N, Cary KC, Einhorn L, Albany C |title=Management of stage I testicular germ cell tumours |journal=Nat Rev Urol |volume=13 |issue=11 |pages=663–673 |date=November 2016 |pmid=27618772 |doi=10.1038/nrurol.2016.164 |url=}}</ref><ref>"NCCN Clinical Practice Guidelines in Oncology: Testicular cancer. National comprehensive cancer network, 2019; https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf."</ref> | ||
* Radiation therapy | * Radiation therapy | ||
Stage IS | Stage IS | ||
Revision as of 16:25, 1 May 2019
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
Stage IA and IB
- Surveillance for pT1-T3 tumors or
- Single agent carboplatin for 1 or 2 cycles followed with chest X-ray and CT scan of the abdomen and pelvis [1][2]
- Radiation therapy
Stage IS
- Recheck the serum marker and the chest X-ray and Ct scan of abdominen and pelvis
Stage IIA
Radiation therapy
- Radiation therapy works best for seminomas. Non-seminomas do not respond well to radiation therapy.
- External beam radiation may be used for stage I and II seminomas after orchiectomy.
- Radiation treatments are usually given once a day, 5 days a week, for 2–4 weeks.
Chemotherapy
Standard-dose chemotherapy
- The most common chemotherapy combinations used to treat testicular cancer are:
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- It is usually given IV every 3 weeks for 2–3 months, or 3 or 4 cycles. In some cases, 1 or 2 cycles may be given for stage I non-seminomas.
- It is used when bleomycin affects the lungs or there is a high risk that it will cause lung damage. It is given IV every 3 weeks for 3 months, or 4 cycles.
- Etoposide, ifosfamide, and cisplatin
- It may be used when bleomycin affects the lungs or there is a high risk that it will cause lung damage. It is given IV every 3 weeks for 3 months, or 4 cycles.
- 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.
- Paclitaxel, ifosfamide and cisplatin
- It is given IV every 3 weeks for 3 months, or 4 cycles.
- Etoposide, ifosfamide and cisplatin.
- It is given IV every 3 weeks for 3 months, or 4 cycles.
- Etoposide or vinblastine, ifosfamide and cisplatin
- It is given IV every 3 weeks for 3 months, or 4 cycles.
High-dose chemotherapy
- High-dose chemotherapy with carboplatin and etoposide may be used if testicular cancer recurs after it is treated with standard-dose chemotherapy.
Palliative chemotherapy
- Palliative therapy is given to relieve symptoms, rather than to treat the cancer itself. Gemcitabine may be given with oxaliplatin, paclitaxel or both as palliative treatment for seminomas or non-seminoma.
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References
- ↑ 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.
- ↑ "NCCN Clinical Practice Guidelines in Oncology: Testicular cancer. National comprehensive cancer network, 2019; https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf."