Stereotactic ablative radiotherapy for oligoprogressive retrocrural nodal metastasis in non-seminomatous germ cell tumour: a case report
Niall O’Sullivan, Lorna KeenanAbstract
Background:
Non-seminomatous germ cell tumours (NSGCTs) are traditionally managed with surgery and chemotherapy, with radiotherapy rarely utilised because of perceived radioresistance. Management of oligoprogressive disease in patients unsuitable for further systemic therapy remains challenging.
Case Presentation:
We report the case of a 53-year-old man with recurrent NSGCT and oligoprogressive retrocrural lymph node metastasis, who was unsuitable for further chemotherapy because of severe neurological complications. He was treated with stereotactic ablative radiotherapy (SABR), 42 Gy in three fractions.
Results:
Treatment was well tolerated, with only Grade 1 asthenia and no significant gastrointestinal toxicity. Radiological and serological surveillance demonstrated sustained response at 15 months.
Conclusion:
This case demonstrates that SABR may represent a safe and effective local treatment option for selected patients with oligoprogressive NSGCT who are unsuitable for systemic therapy.