MRC TE19 / EORTC 30982
In stage I seminoma, can single-dose carboplatin replace adjuvant radiotherapy?
What changes for patients?
At 5 years, relapse-free rate was 94.7% with single-dose carboplatin versus 96.0% with radiotherapy. The reported absolute difference is 1.3 percentage points in favour of RT; this is a non-inferiority comparison, not evidence that carboplatin is superior. The trial’s non-inferiority criterion was met (HR 1.25; 90% CI 0.83–1.89). Do not interpret this as a 1.3% difference in overall survival.
Contralateral testicular germ-cell tumours occurred in 2 patients assigned carboplatin versus 15 assigned RT (HR 0.22; 95% CI 0.05–0.95). These are event counts, not an NNT calculation; the randomized allocation was unequal (573 vs 904).
NNT: Not applicable as a routine summary for this non-inferiority comparison; report the absolute endpoint difference and trial design instead.
Treatment burden and fatigue
NNH: Not quantifiable from the primary publication; carboplatin had less lethargy and less time off work than RT, while acute and late toxicities were otherwise reported descriptively
NON-INFERIOR; HR: 1.25 for relapse with carboplatin vs RT
90% CI 0.83–1.89; non-inferiority margin excluded a doubling of relapse risk
This is a historical randomized comparison, not a complete statement of current stage I seminoma management. Contemporary guidance generally favours active surveillance after orchiectomy when reliable follow-up is feasible. If adjuvant treatment is selected, one dose of carboplatin at AUC 7 is an option; adjuvant radiotherapy is not routinely recommended and is reserved for selected patients. Thus, the practical decision today is usually surveillance versus selected adjuvant carboplatin—not simply carboplatin versus RT.
Guideline context checked 12 October 2026. The trial results above remain the randomized evidence; current recommendations are a separate layer of interpretation.
- Oliver RT, et al. J Clin Oncol. 2011;29:957–962. Primary publication
- European Association of Urology: Testicular Cancer Guidelines (current management context)
- NCI PDQ: Testicular Cancer Treatment (trial summary and dosing caveat)
- EORTC trial record: 30982