Postema, Aniek (2025) Proton beam therapy for stage IIA–B testicular seminoma: Shedding light on acute toxicity and intestinal dosimetric predictors. thesis, Medicine.
Full text available on request.Abstract
Background: Proton beam therapy (PBT) is increasingly used for stage IIA–B testicular seminoma due to its potential to spare healthy tissue. Data on acute toxicity following PBT remains limited. Objective: To identify the frequency, severity and evolution of acute toxicity following PBT for stage IIA–B testicular seminoma and explore associations with intestinal dose distribution. Methods: This retrospective observational cohort study analysed prospectively collected data from 29 patients treated with PBT at the University Medical Centre Groningen. Nausea, diarrhoea and fatigue were graded using Common Terminology Criteria for Adverse Events at baseline, during and after treatment. Cumulative Link Mixed Models analysed evolution over time. Ordinal logistic regression evaluated associations between gastrointestinal toxicity and mean duodenum dose and whole bowel V15 (the bowel volume receiving ≥15 Gy). Results: Acute toxicity was limited to grade I–II. Fatigue and nausea both occurred in 82.8%, diarrhoea in 51.7%. Any gastrointestinal toxicity occurred in 86.2%. Nausea developed early and resolved rapidly after treatment, whereas diarrhoea peaked in week three and gradually declined. Fatigue developed early and persisted long after finishing. Whole bowel V15 was an independent predictor of nausea severity. Mean duodenum dose showed a potential association with diarrhoea severity, although this finding was influenced by a single outlier. Conclusion: PBT for stage IIA–B testicular seminoma results in mild, self-limiting acute toxicity, comparable to photon radiotherapy. Whole bowel V15 predicts nausea severity, mean duodenum dose may predict diarrhoea severity. Further multicentre studies are needed to confirm these findings and assess long-term toxicity.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Sinnige, Drs. P.F. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2026 13:45 |
| Last Modified: | 06 Jan 2026 13:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3876 |
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