Therapeutic Strategy Guided by PET-TDM for Patients With Seminoma

This study is for men who have been diagnosed with seminoma, a type of testicular cancer, that has been confirmed through a biopsy after surgery to remove the testicle (orchiectomy). The cancer must have started in the testicle or in the back of the abdomen (retroperitoneal area). Your blood tests for a marker called alpha-fetoprotein must be normal both before and after your surgery. You must not have had any previous radiotherapy or chemotherapy for your cancer. You need to be at least 18 years old, and generally in good health, meaning you can carry out most daily activities without problems. Your blood counts, liver, and kidney functions must be within certain healthy ranges.

There are also specific requirements depending on whether you have early-stage or more advanced seminoma. For those with early-stage seminoma, you must have what's called 'Grade I'. If your seminoma is more advanced, it needs to fit specific categories of spread, like size of lymph nodes in your abdomen or whether it has spread to areas above your diaphragm, as long as certain blood markers (LDH) aren't too high. For these more advanced cases, your PET-TDM scan must also show active cancer.

You would not be able to join if you have HIV, Hepatitis B or C, or if you've had another type of cancer in the last five years (except treated skin cancer). You also can't have cancer that has spread to your internal organs or brain. If you have serious or uncontrolled heart or liver problems, or if there's any reason your doctor feels the treatment might not be safe for you, you wouldn't be able to participate. You must also be able to understand the study and give your written permission to join.

If you decide to take part in this study, you will have a special scan called a PET-TDM. This scan will help your doctors decide on the best treatment plan for you, which could involve chemotherapy with drugs like Carboplatin, Etoposide, or Cisplatin. The exact schedule of your treatments and follow-up will depend on the stage of your seminoma and the treatment plan chosen based on the scan results. You will have regular appointments for check-ups, blood tests, and scans to monitor your health and how the treatment is working. The study team will explain how many visits you'll need and for how long you'll be followed up. The total duration of your involvement will be thoroughly explained to you before you agree to participate.