Friday 26 April 2013
Giving patients a single dose of chemotherapy alongside radiotherapy could improve outcomes for patients with a type of testicular cancer, a new study suggests.
A pilot study in men with stage IIA and IIB testicular seminoma – where the cancer has spread to the lymph nodes in the abdomen – showed that giving carboplatin before radiotherapy might reduce relapse rates compared with radiotherapy alone.
The clinical study by The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, took 51 men with stage IIA and IIB testicular seminoma and gave them a single cycle of carboplatin – a low toxicity form of chemotherapy – followed three to four weeks later by radiotherapy.
Since carboplatin was added to the regime, a lower dose and a smaller field of radiation seemed appropriate – 39 of the men were given 30 Gy to just the para-aortic lymph node region.
After an average of 4.5 years of follow up, there were no relapses of the cancer compared with a relapse risk of 5-11% after radiotherapy alone. The side- effects from treatment were mild and only lasted a short time.
Professor Alan Horwich, Professor of Radiology at The Institute of Cancer Research (ICR) and Honorary Consultant at The Royal Marsden, said: “The results of this study show great promise. Men who have this stage of testicular seminoma are normally treated with just radiotherapy, or in some countries with intensive combination chemotherapy, where several anticancer drugs are given at once. Relapse occurs in 5-11% of men after radiotherapy alone, and these recurrences have to be treated with combination chemotherapy, which is associated with a risk of serious long-term complications such as cardiovascular disease or second cancers.
“The aim of the study was to develop an effective non-toxic treatment with low risk of long-term treatment complications, and our findings suggest that a single cycle of carboplatin before radiotherapy may reduce the chances of cancer reappearing compared with radiotherapy alone. This will reduce the risk that these patients would need combination chemotherapy. Not only that, but by adding carboplatin to the therapy, the radiation dose and volume can be lowered.”
As this was a small, single-centre study, the researchers are recommending the approach is evaluated more widely.
The study was published in the Annals of Oncology.