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Testicular germ cell cancer: 국가별 선택지

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선택지 정리됨고형암최종 확인 2026.06

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임상시험 검색어

Testicular germ cell cancer clinical trial

국가별 선택지

국가별 치료 선택지

공식 규제·평가 기관 출처를 바탕으로 한 국가별 승인·접근 상태입니다. 무엇이 어디에 존재하는지를 보여줄 뿐, 추천이 아닙니다.

United States

  • adjuvant radiation therapy or adjuvant carboplatin after orchiectomy[1]NCI PDQ: standard optionpostorchiectomy seminoma when surveillance is not chosen; postorchiectomy adjuvant management for stage I seminoma in patients seeking lower relapse risk than surveillance alone. · NCI PDQ also states radiation therapy for stage I seminoma is no longer favored because of evidence of higher secondary-malignancy risk over time. Carboplatin dosing details in the trial used measured GFR-based AUC dosing and are not a substitute for local prescribing protocols. Confidence/conflicts: High for the PDQ listing of adjuvant radiation and carboplatin as options and for the relapse-free-survival figures cited from the randomized evidence summary. No conflict identified in fetched sources.
  • ifosfamide-cisplatin-etoposide or ifosfamide-cisplatin-vinblastine salvage chemotherapy, with surgery favored when technically feasible for late relapse[1]NCI PDQ: standard optionprior cisplatin-based treatment response, disease extent, and late-relapse timing more than 2 years after complete remission; first salvage treatment for recurrent disease and surgery-oriented planning for late relapse. · The PDQ emphasizes that outcomes are most favorable in patients who had a complete initial response and do not have extensive disease. This is a relapse setting with substantial heterogeneity; late-relapse surgery is not a simple substitute for systemic therapy in every case. Confidence/conflicts: High for the PDQ salvage-regimen framing, the no-OS-benefit statement for randomized high-dose chemotherapy, and the late-relapse surgery note. No conflict identified in fetched sources. Standard conventional-dose initial salvage chemotherapy for relapsed germ-cell tumor; long-term complete responses in ~20-30% of patients (NCI PDQ; SEOM-GG 2023). The 'did not show benefit' finding refers ONLY to whether HIGH-DOSE chemotherapy with stem-cell/marrow rescue outperforms conventional-dose salvage (unsettled; subject of the phase III TIGER trial) — not to ICE/VeIP itself. Regimen choice (ICE/VIP, VeIP, TIP, vs high-dose chemo) should be individualized with a germ-cell-tumor specialist.
  • observation, size-based surgery, or PET-guided residual-mass management[1]NCI PDQ: standard optionseminoma histology; residual-mass size and postchemotherapy FDG-PET context; postchemotherapy management of residual masses in metastatic seminoma. · The PDQ also notes that PET has a substantial false-positive rate in some series and that residual-mass size alone has limited prognostic value. This is a management framework, not a guarantee that a residual mass is inactive. Confidence/conflicts: High for the PDQ description of the three standard seminoma residual-mass strategies and its PET caveat. No conflict identified in fetched sources.
  • orchiectomy followed by surveillance, retroperitoneal lymph node dissection, or short-course chemotherapy[1]NCI PDQ: standard optionnonseminoma postorchiectomy with negative CT and serum markers for surveillance eligibility; relapse-risk reduction strategies include RPLND or one to two cycles of chemotherapy; postorchiectomy stage I nonseminoma management when deciding between surveillance and relapse-risk-reduction strategies. · The PDQ emphasizes that surveillance should only be used when CT imaging and markers are negative and when the patient and treating team can maintain a rigorous follow-up schedule. It does not establish a single universally preferred option across all stage I nonseminoma presentations. Confidence/conflicts: High for the PDQ summary of stage I nonseminoma management choices and cure/relapse framing. No conflict identified in fetched sources.
  • radical inguinal orchiectomy followed by cisplatin-based chemotherapy with BEP or EP[1]NCI PDQ: standard optionIGCCCG good-risk metastatic classification; seminoma versus nonseminoma and bleomycin-contraindication context; first-line treatment of good-risk metastatic testicular germ cell tumor after diagnosis and risk stratification. · This is a U.S. national cancer-agency treatment summary, not a payer-coverage document. The regimen choice depends on risk grouping, seminoma versus nonseminoma, and whether bleomycin is safe to use. Confidence/conflicts: High for the PDQ regimen framing of BEP and EP in good-risk metastatic disease. No conflict identified in fetched sources.
  • radical inguinal orchiectomy followed by cisplatin-based chemotherapy with BEP or VIP[1]NCI PDQ: standard optionIGCCCG intermediate- or poor-risk metastatic classification; bleomycin-contraindication context; first-line treatment of intermediate- or poor-risk metastatic testicular germ cell tumor. · The PDQ language is risk-group based and does not turn VIP into a universal substitute for every metastatic presentation. This summary also does not settle institutional preferences around sequencing surgery and chemotherapy in a specific urgent case. Confidence/conflicts: High for the PDQ framing of BEP and VIP in higher-risk metastatic disease and the bleomycin-contraindication note. No conflict identified in fetched sources.
  • radical inguinal orchiectomy followed by surveillance[1]NCI PDQ: standard optionpure seminoma context; postorchiectomy surveillance selection with relapse-risk modifiers including tumor size >4 cm and rete testis invasion; postorchiectomy management of stage I seminoma when active surveillance is acceptable. · Surveillance requires repeated imaging and follow-up over years, so this is not merely a one-time treatment choice. The PDQ reports risk modifiers but does not turn them into a single mandatory cutoff for all patients. Confidence/conflicts: High for surveillance as a standard stage I seminoma option and for the PDQ relapse/cure framing. No conflict identified in fetched sources.
  • radical inguinal orchiectomy with preoperative serum-marker staging[1]NCI PDQ: standard optionserum tumor markers AFP, beta-hCG, and LDH measured before orchiectomy; elevated AFP means the tumor should be managed as nonseminoma even if pathology appears pure seminoma; initial diagnosis and first definitive treatment planning for suspected malignant testicular germ cell tumor. · This is a U.S. national cancer-agency treatment summary, not a payer-coverage or institution-specific pathway. It does not replace pathology review, imaging, or marker interpretation in a specialist germ-cell tumor team. Confidence/conflicts: High for the NCI PDQ description of marker-based staging and radical inguinal orchiectomy as the standard initial procedure. No conflict identified in fetched sources.
  • surgical resection of all technically feasible residual masses, with salvage chemotherapy if tumor markers are rising[1]NCI PDQ: standard optionnonseminoma histology; residual-mass feasibility for resection; serum tumor-marker trend context; postchemotherapy residual-mass management in metastatic nonseminoma. · The PDQ notes that surgery is not usually performed when only some but not all residual masses can be resected, and that predicting necrosis versus viable tumor remains unreliable. This is a technically demanding postchemotherapy setting. Confidence/conflicts: High for the PDQ standard-of-care statement on nonseminoma residual-mass resection and its marker-based salvage note. No conflict identified in fetched sources.

European Union

  • BEP chemotherapy by prognosis group, plus surgical resection of residual NSGCT masses after chemotherapy[2]Standard option (per European Association of Urology)IGCCCG prognosis-group classification for seminoma; serum-tumour-marker normalization context for residual NSGCT masses; metastatic seminoma first-line systemic treatment and postchemotherapy residual-mass management in metastatic NSGCT. · This finding combines two adjacent metastatic-management recommendations from the same guideline. It does not verify member-state reimbursement, center availability of high-volume residual-mass surgery, or country-specific chemo funding rules. Confidence/conflicts: High for the EAU metastatic seminoma BEP-by-prognosis recommendation and the strong recommendation to resect visible residual NSGCT masses when markers normalise. No conflict identified in the fetched guideline.
  • carboplatin adjuvant chemotherapy; radiotherapy de-emphasized[2]Standard option (per European Association of Urology)no molecular biomarker gating stated; pathological risk-factor framing after orchidectomy; adjuvant-treatment decision after orchidectomy for clinical stage I seminoma when surveillance is not chosen. · The guideline frames this as an option, not a default. It does not verify country-by-country reimbursement, procurement, or local radiotherapy access policies. Confidence/conflicts: High for the EAU carboplatin AUC7 recommendation and its routine-radiotherapy caution. No conflict identified in the fetched guideline.
  • one course of BEP, with surveillance as an alternative and highly selective nerve-sparing RPLND[2]Standard option (per European Association of Urology)no molecular biomarker gating stated; lymphovascular invasion present, marking higher relapse risk; postorchiectomy management of higher-risk clinical stage I nonseminoma with lymphovascular invasion. · This is a risk-adapted European guideline recommendation, not an EU authorization or payer rule. It does not imply that RPLND is routinely preferred over BEP. Confidence/conflicts: High for the EAU high-risk stage I nonseminoma recommendation tying LVI-positive disease to one-cycle BEP preference with surveillance still discussable. No conflict identified in the fetched guideline.
  • surveillance after orchidectomy[2]Standard option (per European Association of Urology)no molecular biomarker gating stated; seminoma histology and recurrence-risk-factor context after orchidectomy; postorchiectomy management of clinical stage I seminoma. · This is a European professional-society guideline, not an EU reimbursement or country formulary source. The recommendation depends on surveillance resources and patient ability to comply with follow-up. Confidence/conflicts: High for the 2026 EAU recommendation making surveillance the preferred postorchiectomy option in compliant stage I seminoma patients. No conflicting primary European guideline was reviewed in this cycle.
  • surveillance, with one course of BEP as the non-surveillance alternative[2]Standard option (per European Association of Urology)no molecular biomarker gating stated; stage IA pT1 disease without lymphovascular invasion; postorchiectomy management of low-risk clinical stage I nonseminoma. · This is guideline logic rather than a regulator label. The choice depends heavily on willingness and ability to complete surveillance, not on a drug-approval comparison. Confidence/conflicts: High for the EAU low-risk stage I nonseminoma surveillance-versus-single-cycle-BEP framing. No conflict identified in fetched sources.

United Kingdom

  • active surveillance with tumour markers, imaging, and scheduled follow-up[3]Standard option (per Cancer Research UK)no molecular biomarker gating stated; seminoma versus nonseminoma histology drives surveillance schedule differences; postorchiectomy monitoring for stage I low-risk testicular cancer. · This page describes a U.K. monitoring pathway, not an individualized relapse-risk calculator. It does not replace specialist judgment on who is suitable for surveillance. Confidence/conflicts: High for the U.K. surveillance framing, minimum follow-up duration, and seminoma-versus-nonseminoma visit-frequency distinction on the fetched page. No conflicting source was reviewed in this cycle.
  • carboplatin alone or combination chemotherapy including BEP, EP, VeIP, VIP, TIP, or GIP[4]Standard option (per Cancer Research UK)no molecular biomarker gating stated; systemic-treatment need driven by relapse risk, recurrence, or spread; adjuvant, metastatic, or relapsed testicular-cancer systemic-treatment settings. · The page names regimen options but does not assign each regimen to a precise stage or risk group in the fetched text. It is a treatment-information source, not a drug label or commissioning protocol. Confidence/conflicts: High for the listed U.K. chemotherapy use-cases and named regimens on the fetched Cancer Research UK page. No conflicting U.K. source was reviewed in this cycle.
  • external-beam radiotherapy[5]Standard option (per Cancer Research UK)seminoma histology; no molecular biomarker gating stated; seminoma with retroperitoneal nodal spread, or selected situations where chemotherapy is unsuitable. · The page is specific to seminoma and does not imply a routine radiotherapy role for nonseminomatous disease. It also does not provide detailed U.K. dose schedules or commissioning criteria. Confidence/conflicts: High for the U.K. seminoma-specific retroperitoneal-node radiotherapy use-case on the fetched page. No conflicting source was reviewed in this cycle.
  • orchidectomy first, with retroperitoneal lymph node dissection or lung surgery in selected spread patterns[6]Standard option (per Cancer Research UK)no molecular biomarker gating stated; treatment-pathway decision by stage, histology, and spread; initial management of testicular cancer, with additional surgery in selected nodal or lung-metastatic settings. · These are national treatment-information pages rather than a formal NICE technology appraisal or regimen-specific commissioning policy. They do not define exact case-selection criteria for RPLND or lung metastasectomy. Confidence/conflicts: High for the U.K. surgery-first pathway and the existence of selected lymph-node or lung surgery contexts on the fetched national pages. No conflict identified between the NHS and Cancer Research UK sources.
  • second-line VIP or TIP chemotherapy, possible high-dose chemotherapy with stem-cell transplant, and selected post-relapse retroperitoneal surgery[7]Standard option (per Cancer Research UK)relapse decision-making depends on tumour markers, prior treatment response, histology, relapse timing, and disease location rather than a molecular biomarker; relapsed testicular cancer, including second-line systemic therapy and selected late-relapse surgical planning. · This is relapse-pathway guidance, not a formal U.K. protocol assigning one salvage strategy to every relapse. It does not establish transplant eligibility criteria or center-specific access thresholds. Confidence/conflicts: High for the U.K. relapse-treatment framing, named VIP/TIP second-line regimens, high-dose chemotherapy mention, and late-relapse surgery-versus-chemotherapy distinction on the fetched page. No conflicting source was reviewed in this cycle.
  • surgery with possible chemotherapy or radiotherapy, plus sperm banking before fertility-affecting treatment[8]Standard option (per NHS)no biomarker gating stated; treatment depends on cancer type, size, spread, and fertility planning; general U.K. treatment-pathway and fertility-preservation planning before definitive therapy. · This is a public NHS overview, not a detailed stage-specific oncology protocol. It does not specify seminoma-versus-nonseminoma algorithms or exact chemotherapy regimens. Confidence/conflicts: High for the NHS pathway overview stating surgery-first management with possible chemo/radiotherapy and pre-treatment sperm-banking offer. No conflict identified in fetched sources.

출처

  1. National Cancer Institute — national cancer agency PDQ · national cancer agency PDQ
  2. European Association of Urology (EAU) — regional clinical guideline PDF · regional clinical guideline PDF
  3. Cancer Research UK — national cancer charity surveillance information page · national cancer charity surveillance information page
  4. Cancer Research UK — national cancer charity chemotherapy information page · national cancer charity chemotherapy information page
  5. Cancer Research UK — national cancer charity radiotherapy information page · national cancer charity radiotherapy information page
  6. Cancer Research UK — national cancer charity treatment information page · national cancer charity treatment information page
  7. Cancer Research UK — national cancer charity relapse-treatment information page · national cancer charity relapse-treatment information page
  8. NHS — national health service treatment overview · national health service treatment overview

위 내용은 공식 규제·접근 상태일 뿐, 의학적 조언이나 추천이 아니고, 적격성을 판단하지도 않습니다. 어떤 선택지가 적합한지는 환자의 상황과 종양내과 팀에 달려 있습니다. 규제 상태는 바뀔 수 있으니 표시된 출처에서 확인하세요. 임상 세부 내용은 영문이 정본입니다. 최종 확인 2026-06-13.