Testicular cancer medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
Seminoma | |||
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. | |||
===Radiation therapy=== | ===Radiation therapy=== | ||
* [[Radiation therapy]] works best for seminomas. Non-seminomas do not respond well to radiation therapy. | * [[Radiation therapy]] works best for seminomas. Non-seminomas do not respond well to radiation therapy. | ||
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===Chemotherapy=== | ===Chemotherapy=== | ||
'''Standard-dose chemotherapy''' | '''Standard-dose chemotherapy''' | ||
* The most common [[chemotherapy]] combinations used to treat testicular cancer are: | * The most common [[chemotherapy]] combinations used to treat testicular cancer are: | ||
:* [[Bleomycin]], [[etoposide]], and [[cisplatin]] | :* [[Bleomycin]], [[etoposide]], and [[cisplatin]] | ||
| Line 34: | Line 38: | ||
'''Palliative 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- | * 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== | ==References== | ||
Revision as of 07:18, 29 April 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
Seminoma 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.
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.<ref>Testicular cancer.2015 Canadian Cancer Society.
- 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:
-
- 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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