Radiotherapy for early stages testicular seminoma: patterns of care study in Germany

Abstract

Background and purpose: To evaluate compliance of radiotherapeutic departments with 1997 German consensus guidelines for staging and treatment of testicular cancer patients. Material and methods: A questionnaire was mailed to all departments of radiotherapy in Germany as identified by the data-base of the German Society for Radiation Oncology (DEGRO). The questionnaire was analysed with particular respect to institutional characteristics, frequency of seminoma patients treated per year, treatment techniques, and institutional compliance with consensus guidelines. Results: Fifty-six institutions (39%) returned the questionnaire, 46% of which fully complied with consensus guidelines concerning staging requirements. A minimum workup with computed tomography (CT) of abdomen and pelvis, X-ray or CT of the chest and tumour markers was mandatory in 87.5% of the departments. Compliance with the recommended treatment schedule was high in stage I with less than 5% major violations of recommended dose prescription or target volume definition. In stage IIA/B, however, 22.6 and 10.2% of the departments showed major deviations from either standardised treatment target volumes or total doses of irradiation, respectively. Conclusions: Compliance with consensus recommendations in German departments for radiotherapy is satisfactory in many institutions. However, major deviations from treatment guidelines were observed in stage II disease indicating the need for continuous improvement in the quality of testicular cancer patient management.