Center of Clinical Epidemiology, Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Hufelandstr. 55, 45147, Essen, Germany.
Radiology Office, Hospital St. Elisabeth and St. Barbara, Mauerstraße 5, 06110, Halle, Germany.
Eur Radiol. 2019 Jul;29(7):3918-3926. doi: 10.1007/s00330-019-06148-1. Epub 2019 Apr 23.
Computed tomography (CT) examinations are frequent in follow-up care of testicular cancer (TC) but may increase the risk for other cancers. We wanted to assess the actual number of CT and X-ray examinations within the first 5 years after a diagnosis of TC in Israel during 2003-2007.
The database of Maccabi Healthcare Services, Israel, was searched for TC patients diagnosed in 2003 to 2007 by direct linkage with the Israel National Cancer Registry. Data on diagnostic imaging examinations (CT of chest, abdomen, or pelvis, unspecified sites; X-ray of chest) were extracted during a 5-year follow-up for 226 incident patients. The actual number of CT and X-ray examinations was compared to the National Comprehensive Cancer Network (NCCN) guideline. We tabulated the median with 10th and 90th percentiles (P10, P90) for the number of CTs and X-rays considering histology, stage, and adjuvant strategy.
The number of abdomen or pelvis CTs for TC patients receiving chemo- or radiotherapy was in accordance with the NCCN guideline. The median of abdomen or pelvis CTs for surveillance patients was 8.5 (P10, P90: 3; 13) for nonseminoma and 5.0 (P10, P90: 5; 13) for seminoma patients compared to 14 to 17 CTs recommended. The number of chest X-rays was lower than recommended in the guideline for all adjuvant strategies.
The NCCN guidelines regarding CTs were met for TC patients treated with chemo- or radiotherapy but fell below recommendations for surveillance. Guidelines from 2011 and 2012 were updated in favor of fewer CTs during surveillance.
• The number of CTs followed the NCCN guidelines in patients treated with chemo- or radiotherapy. • Surveillance patients received fewer CTs and X-rays than recommended in the NCCN guidelines from 2005. • The number of applied CT examinations corresponded to a radiation dose that did not substantially raise the lifetime risk for cancer.
计算机断层扫描（CT）检查在睾丸癌（TC）的随访中很常见，但可能会增加其他癌症的风险。我们想评估 2003-2007 年期间以色列诊断为 TC 后的前 5 年内 CT 和 X 射线检查的实际数量。
通过与以色列国家癌症登记处的直接链接，搜索 Maccabi 医疗保健服务的数据库，以查找 2003 年至 2007 年期间诊断的 TC 患者。在 226 例偶发患者的 5 年随访期间，提取了胸部、腹部或骨盆的 CT（未指定部位）和胸部 X 射线的诊断影像学检查数据。实际的 CT 和 X 射线检查数量与国家综合癌症网络（NCCN）指南进行了比较。我们根据组织学、分期和辅助治疗策略列出了 CT 和 X 射线数量的中位数以及第 10 个和第 90 个百分位数（P10、P90）。
接受化疗或放疗的 TC 患者的腹部或骨盆 CT 数量符合 NCCN 指南。接受监测的非精原细胞瘤患者的腹部或骨盆 CT 中位数为 8.5（P10、P90：3；13），精原细胞瘤患者为 5.0（P10、P90：5；13），而推荐的 CT 数量为 14-17 次。所有辅助治疗策略的胸部 X 射线数量均低于指南推荐。
接受化疗或放疗的 TC 患者的 CT 检查符合 NCCN 指南，但低于监测建议。2011 年和 2012 年的指南更新为监测期间的 CT 次数减少提供了依据。
在接受化疗或放疗的患者中，CT 检查数量符合 NCCN 指南。
监测患者接受的 CT 和 X 射线数量低于 NCCN 指南 2005 年的建议。
应用的 CT 检查次数对应的辐射剂量不会显著增加终生癌症风险。
