a 12-years study of curative radiotherapy in testicular seminoma patients referred to tehran cancer institute's radiation-oncology department

testicular germ-cell tumors are the most common malignancy among men aged 20-40 years, and 60 percent of them are seminomas. these tumors are now an important socio-economic problem, considering their growing incidence. thus we undertook to evaluate the results of curative irradiation in our testicular seminoma patients and compare them to literature results considering the use of cobalt-60 systems in our department (in contrast to the use of linear accelerators). all testicular seminoma cases referred after orchiectomy to radiation-oncology department of tehran cancer institute and treated curatively during the 12-years period of 1987-1998 were reviewed. these included 147 patients. the results showed a mean age of 34.5 years. eighty-six patients (58.5 percent) were in stage i, 57 (38.8 percent) in stage ii and 4 (2.7 percent) in stage iii. with a mean follow-up time of 53.5 months (range 2-158 months) after radiotherapy, there were 12 (9 percent) local relapses and 8 (6.5 percent) distant metastases among the 122 patients who came back for follow-up. the 10-years overall survival was 97.9 percent and disease-free survival 79.7 percent (life-tables). mean overall and disease-free survival time was 155 and 133 months respectively, with a median survival time of more than 158 months (kaplan-meier). the only significant prognostic factor was stage of the disease (p=0.01), though lactate dehydrogenase (ldh) was significant only in multi-factorial analysis (p=0.02). in conclusion, our survival figures were all favorably comparable to literature results, considering the higher ratio of stage ii in our patients. we recommend training of young men for testicular self-examination and a greater attention to ldh measurement, and hope for installation of linear accelerators in our department to further improve the treatment results with less side effects.