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Germ Cell Tumours · Radiation Oncology · Stage I Seminoma

MRC TE10

In stage I seminoma, can the radiation field be reduced from dog-leg to para-aortic only without compromising relapse control?

Population478 men with stage I seminoma.InterventionPara-aortic strip radiotherapy, 30 Gy in 15 fractions.ComparatorPara-aortic + ipsilateral iliac (dog-leg) field, 30 Gy in 15 fractions.Primary clinical outcomeRelapse-free survival and toxicity.

Absolute Effect

Five-year relapse-free rates were 96.1% vs 96.2%, an absolute difference of only 0.1 percentage point. The mature relapse HR was 1.15 (90% CI 0.54–2.44).

Clinical interpretation

Reducing the field did not materially change overall relapse-free survival, while acute gastrointestinal/hematologic toxicity and gonadal toxicity were lower with para-aortic treatment. Pelvic relapse was more frequent after para-aortic-only RT, but total relapse remained very low.

Source

Fossa SD, et al. J Clin Oncol. 1999;17:1146. Mature follow-up: Mead GM, et al. JNCI. 2011;103:241–249.

Current-practice context · reviewed 14 October 2026

MRC TE10 showed similar relapse control with para-aortic-only versus dog-leg radiotherapy in stage I seminoma, reducing the treated volume. Contemporary stage I seminoma management often favours surveillance or selected adjuvant carboplatin, with radiotherapy reserved for carefully selected patients because of late second-malignancy and cardiovascular risks. If RT is chosen, field and dose should follow current guidance and minimize normal-tissue exposure.

MRC TE10 primary source ↗ · Current guideline guidance ↗