Neoadjuvant carboplatin before radiotherapy in stage IIA and IIB seminoma

Ann Oncol. 2013 Aug;24(8):2104-7. doi: 10.1093/annonc/mdt148. Epub 2013 Apr 16.


Background: Extended field radiotherapy is a standard of care for low volume stage II testicular seminoma. We hypothesized that neoadjuvant carboplatin might reduce the recurrence risk.

Patients and methods: In a single-arm study, 51 patients were treated between May 1996 and November 2011 with a single cycle of carboplatin followed by radiotherapy. The radiation field was reduced from an extended abdomino-pelvic field to just the para-aortic region, and the radiation dose from 35 Gy to 30 Gy in 39 patients.

Results: After a median follow-up of 55 months (range 8-151 months) with 38 (74%) of the patients having been followed for >2 years, there have been no relapses (95% confidence limits of 5-year relapse-free survival of 93%-100%). Toxicity has been low with grade 3 toxicity limited to four patients with grade 3 haematological toxicity (with no clinical sequelae) and one patient with grade 3 nausea (during radiotherapy). No patients experienced grade 4 toxicity.

Conclusions: The results of this pilot study suggest that a single cycle of neoadjuvant carboplatin before radiotherapy may reduce recurrence risk compared with radiotherapy alone and permit a smaller radiation field, and this approach is proposed for further investigation.

Keywords: carboplatin; germ cell tumour; radiotherapy; seminoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Carboplatin / therapeutic use*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Seminoma / drug therapy*
  • Seminoma / radiotherapy*
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / radiotherapy
  • Young Adult


  • Antineoplastic Agents
  • Carboplatin