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  • Torgrim Tandstad

New protocol for seminoma SWENOTECA IX


A new protocol for seminoma is now available. It replaces SWENOTECA VII from October 1, 2014.

The major changes in the guideline are:

  • Stage I:

  • Patients with tumour size 4 cm or less and without invasion of the rete testis are recommended surveillance.

  • Patients with tumour size more than 4 cm or invasion of the rete testis are recommended adjuvant carboplatin. Surveillance may be an option to those patients not wanting adjuvant treatment.

  • Stage II A

  • ​Chemotherapy in the form of BEP x 3 or radiotherapy 2 Gy x 15 to 30 Gy to the para-aortic, the ipsilateral common iliac- and the external iliac lymph nodes may be used as primary treatment

  • Stage II B-IV

  • The standard treatment is BEP x 3. In patients with contraindication to bleomycin EP x 4 should be used.

  • Radiotherapy for cancer in situ (CIS) in the contralateral testicle:

Many SWENOTECA centers have prescribed an average target dose of 16 Gy, 2 Gy x 8. And therefore a part of the testicle has got a dose < 16 Gy. There have been relapses after irradiation for CIS. Our new recommendation is therefore: The target dose should be average 18 Gy, 2 Gy x 9, in order to get a minimum dose of 17 Gy in the testicle.

For full information see SWENOTECA IX

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