Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial

In a large randomized study authors compared radiotherapy (n = 904) with one injection of carboplatin (n = 573) in the treatment of stage 1 seminoma. With a median four years follow-up, relaps-free survival rates for radiotherapy and carboplatin were similar (96.7% and 97.7%, respectively) at three years. Patients given carboplatin were less lethargic and less likely to take time off work than those given radiotherapy. Also, contralateral testicular germ-cell tumours were reported in ten patients allocated irradiation and to allocated carboplatin. One seminoma-related death occurred after radiotherapy and none after carboplatin. The trial has shown the non-inferiority of carboplatin to radiotherapy in the treatment of stage 1 seminoma in the short term. However, these findings need to be confirmed beyond four years follow-up.