Role of radiotherapy in the management of testicular cancer: Recommendations from the French society for radiation oncology

This article aims to report the recommendations from the French society for radiation oncology (Société française de radiothérapie oncologique, SFRO) on the use of external beam radiotherapy in the management of testicular cancer. Testicular cancers account for 1 % of adult neoplasms yet represent the most frequently diagnosed urological tumour in young men. Most of testicular cancers (95 %) are germ cell tumours, which include both seminomatous and non-seminomatous tumours. Surveillance is the preferred option for stage I seminoma following orchidectomy, but adjuvant chemotherapy or para-aortic radiotherapy remain possible options. For stages IIA/IIB seminoma, either chemotherapy or para-aortic and ipsilateral iliac nodal areas irradiation can be proposed. In non-seminomatous tumours, chemotherapy is the standard treatment. Target volumes, doses, fractionation regimens, and considerations for organs at risk are discussed. Follow-up recommendations are provided, aiming to ensure both early detection of cancer recurrence and late treatment-related side effects. These guidelines highlight the importance of a multidisciplinary approach for the management of germ cell tumours as well as careful consideration of long-term toxicities, in this young patient population with a long-life expectancy.