Testicular seminoma revisited: Time for a multimodal therapeutic approach
The development of effective chemotherapy regimens for germ-cell carcinoma has mandated a reassessment of the management of testicular seminoma, since patients with advanced seminoma respond poorly to radiotherapy. Although traditional radiotherapy regimens are effective against clinical Stages A and B1 disease, cisplatin-based chemotherapy may be preferable for Stages B2 and C disease. Alternatively, vinblastine, actinomycin D (dactinomycin), and cyclophosphamide may be used in conjunction with consolidation radiotherapy, reserving cisplatin and bleomycin for salvage treatment. In stage D disease, cisplatin-based chemotherapy may be advisable. The use of CT scans to improve the accuracy of clinical staging is suggested. © 1984 Springer-Verlag.
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