Stage IIB seminoma involves regional lymph node involvement requiring active locoregional or systemic management. When a patient is unsuitable for chemotherapy, an evidence-based alternative treatment path applies — distinct from the standard first-line systemic approach.
This protocol is for patients with seminoma stage IIB who are unsuitable for chemotherapy. Chemotherapy unsuitability — whether due to contraindications, comorbidities, or patient factors — defines this sub-population and drives the selection of an alternative management strategy.
In this setting, radiation therapy directed at specific regional nodal fields is the recommended modality. The precise field configuration, dose level, and fractionation schedule are defined in the full structured protocol.
DOI: 10.1016/j.annonc.2022.01.002
Patients with stage IIB seminoma unsuitable for ChT should receive para-aortic and ipsilateral iliac field RT up to 36 Gy in 2 Gy fractions.
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