Transient neurological adverse effects following low dose radiation therapy for early stage testicular seminoma.

BACKGROUND AND PURPOSE

The aim of this study was to estimate the rate of neurological adverse effects following radiotherapy for testicular seminoma and to disclose possible dose-related effects.

PATIENTS AND METHODS

All seminoma patients (n=346) treated 1980-2001 at our department with radiotherapy as the only treatment modality following orchiectomy constitute the study group (median follow-up 10 years). Since 1980, clinical data including possible side effects have systematically been recorded in these patients. These records were used to identify men with possible neurological adverse effects. Univariate logistic regression was used to estimate dose-related effects.

RESULTS

Overall, 11 men (3.2%) with neurological symptoms probably related to radiotherapy were identified. Seven men treated with 25.2-36 Gray presented with sensory symptoms about 2 months following radiotherapy. These symptoms resolved in all but one after 1-3 months. The remaining four men (dose 36-40 Gray) had motor impairment which lasted at least one year, but none had persistent pareses at long-term follow-up. There was a statistically significant (p=0.02) increase in rate of motor symptoms with higher dose.

CONCLUSIONS

Although motor impairment is unlikely to occur at current standard doses for seminomas, physicians should be ware of the sensory symptoms these men may exhibit.