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Low-dose radiation therapy for testicular intraepithelial neoplasia

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  • Clinical Oncology
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Abstract

Four patients with unilateral testicular germ-cell tumor and biopsy-proven contralateral testicular intraepithelial neoplasia (TIN; so-called carcinoma in situ) received localized low-dose radiation therapy (18–20 Gy) of the testis with TIN. Repeated biopsies disclosed the disappearance of TIN and germ cells. No recurrence of TIN or germ cells was observed after a follow-up of 18–42 months. All patients reported a normal sex life without need of androgen supplementation. Serum follicle-stimulating hormone increased significantly immediately after radiation treatment and started to decline after 24 months. Serum luteinizing hormone increased slightly but not significantly. A decline after 24 months was observed in only one of three patients. Serum testosterone decreased significantly in all patients after 1 year but never became subnormal. Low-dose radiation treatment is efficacious in eradicating testicular intraepithelial neoplasia without destroying Leydig cells or stromal cells of the testis. Thus, a patient otherwise destined to develop a second testicular tumor can be spared orchiectomy and life-long hormonal replacement.

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References

  • Cameron KM, Pugh RCB (1976) Effects of radiation. In: Pugh, RCB (ed) Pathology of the testis. Blackwell, Oxford, pp 457–459

    Google Scholar 

  • Dieckmann K-P, Loy V (1991) Persistent testicular intraepithelial neoplasia after chemotherapy. Eur Urol 20:258–260

    PubMed  Google Scholar 

  • Dieckmann K-P, Loy V, Huland H (1989) Das Carcinoma in situ des Hodens: klinische Bedeutung, Diagnose und Therapie. Urologe [A] 28:271–280

    Google Scholar 

  • Dieckmann K-P, Loy V, Büttner P (1993) Prevalence of bilateral testicular germ cell tumours and early detection based on contralateral testicular intraepithelial neoplasia. Br J Urol (in press)

  • Fleck H, Stahl F, Mau S (1981) Untersuchungen über die Ausschaltung der testikulären Testosteronproduktion durch Hodenbestrahlung bei Patienten mit Prostatakarzinom. Z Urol Nephrol 74:443–446

    PubMed  Google Scholar 

  • Fordham MVP, Mason MD, Blackmore C, Hendry WF, Horwich A (1990) Management of the contralateral testis in patients with testicular germ cell cancer. Br J Urol 65:290–293

    PubMed  Google Scholar 

  • Giwercman A, Berthelsen JG, Müller J, Maase H von der, Skakkebaek NE (1987) Screening for carinoma in situ of the testis. Int J Androl 10:173–180

    PubMed  Google Scholar 

  • Giwercman A, Maase H von der, Berthelsen JG, Rorth M, Bertelsen A, Skakkebaek NE (1991) Localized irradiation of testes with carcinoma in situ: effects on Leydig cell function and eradication of malignant germ cells in 20 patients. J Clin Endocrinol Metabol 73:596–603

    Google Scholar 

  • Greiner R (1982) Die Erholung der Spermatogenese nach fraktionierter, niedrig dosierter Bestrahlung der männlichen Gonaden. Strahlentherapie 158:342–355

    PubMed  Google Scholar 

  • Hoff Wanderas E, Fossa SD, Heilo A, Stenwig AE, Norman N (1990) Serum follicle stimulating hormone-predictor of cancer in the remaining testis in patients with unilateral testicular cancer. Br J Urol 66:315–317

    PubMed  Google Scholar 

  • Howard GCW, Hargreave TB, McIntyre MA (1989) Case report: carcinoma in situ of the testis diagnosed on semen cytology. Clin Radiol 40:323–324

    PubMed  Google Scholar 

  • Kleinschmidt K, Weissbach L, Holstein AF (1989) Früherkennung des kontralateralen Zweitkarzinoms bei Hodentumorpatienten durch das carcinoma in situ testis. Urologe [A] 28:281–284

    Google Scholar 

  • Kratzik C, Aiginger P, Kuber W, Riccabona M, Kührer I, Joos H, Frick J, Amman G, Mayr W (1991) Risk factors for bilateral testicular germ cell tumors. Does heredity play a role? Cancer 68:916–921

    PubMed  Google Scholar 

  • Loy V, Dieckmann KP (1990) Carcinoma in situ of the testis: Intratubular germ cell neoplasia or testicular intraepithelial neoplasia? Hum Pathol 21:457

    PubMed  Google Scholar 

  • Loy V, Wigand I, Dieckmann K-P (1990) Screening for carcinoma in situ testis by random surgical biopsy: possible false negative results. Histopathology 16:198–200

    PubMed  Google Scholar 

  • Maase H von der, Giwercman A, Müller J, Skakkebaek NE (1987) Management of carcinoma in situ of the testis. Int J Androl 10:209–220

    PubMed  Google Scholar 

  • Maase H von der, Giwercman A, Skakkebaek NE (1986) Radiation treatment of carcinoma-in-situ of testis. Lancet I:624–625

    Google Scholar 

  • Mougharbel S, Aftimos G, Ghosn S (1990) Carcinome in situ du testicule (CIST). A propos de 7 cas. J Urol (Paris) 96:25–29

    Google Scholar 

  • Mumperow E, Lauke H, Holstein AF, Hartmann M (1992) Further practical experiences in the recognition and management of carcinoma in situ of the testis. Urol Int 48:162–166

    PubMed  Google Scholar 

  • Read G (1987) Carcinoma in situ of the contralateral testis (letter). Br Med J 294:121

    Google Scholar 

  • Rowley MJ, Leach DR, Warner GA, Heller CG (1974) Effect of graded doses of ionizing radiation on the human testis. Radiat Res 59:665–678

    PubMed  Google Scholar 

  • Sachs L (1984) Angewandte Statistik: 6. Auflage. Springer, Berlin Heidelberg New York, pp 242–246

    Google Scholar 

  • Shalet SM, Tsatsoulis A, Whitehead E, Read G (1989) Vulnerability of the human Leydig cell to radiation damage dependent upon age. J Endocrinol 120:161–165

    PubMed  Google Scholar 

  • Shapiro E, Kinsella TJ, Makuch RW, Fraass BA, Glatstein E, Rosenberg SA, Sherins RJ (1985) Effects of fractionated irradiation on endocrine aspects of testicular function. J Clin Ongol 3:1232–1239

    Google Scholar 

  • Skakkebaek NE (1972) Possible carcinoma in situ of the testis. Lancet ii:516–517

    Google Scholar 

  • Skakkebaek NE (1978) Carcinoma in situ of the testis: frequency and relationship to invasive germ cell tumours in infertile men. Histopathology 2:157–170

    PubMed  Google Scholar 

  • Skakkebaek NE, Berthelsen JG (1978) Carcinoma in situ of testis and orchiectomy. Lancet ii:204–205

    Google Scholar 

  • Skakkebaek NE, Berthelsen JG, Giwercman A, Müller J (1987) Carcinoma in situ of the testis: possible origin from gonocytes and precursor of all types of germ cell tumours except spermatocytoma. Int J Androl 10:19–28

    PubMed  Google Scholar 

  • Sklar CA, Robison LL, Nesbit ME, Sather HN, Meadows AT, Ortega JA, Kim TH, Hammond GD (1990) Effects of radiation on testicular function in long-term survivors of childhood acute lymphoblastic leukemia: a report from the childrens cancer study group. J Clin Oncol 8:1981–1987

    PubMed  Google Scholar 

  • Tomic R, Bergman B, Damber J-E, Littbrand B, Löfroth PO (1983) Effects of external radiation therapy for cancer of the prostate on the serum concentrations of testosterone, follicle-stimulating hormone, luteinizing hormone, and prolactin. J Urol 130:287–289

    PubMed  Google Scholar 

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Dieckmann, KP., Besserer, A. & Loy, V. Low-dose radiation therapy for testicular intraepithelial neoplasia. J Cancer Res Clin Oncol 119, 355–359 (1993). https://doi.org/10.1007/BF01208845

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