뇌종자세포종(Intracranial Germinoma)의 치료에 있어 방사선 단독 치료와 방사선 및 약물 병용 치료군에서의 방사선 용량 비교

Abstract

Purpose: Intracranial germinoma is the most frequent intracranial germ cell tumor. Radiotherapy has so far been considered as the standard treatment. Radiotherapy could unfavorably affect the quality of life, so there have been many trials to reduce the radiation dose. We report significant reduction of radiation dose on tumor field when it was combined with chemotherapy.

Methods: From January 1997 to January 2007, 31 patients were enrolled in this study. 12 patients received radiotherapy alone, 19 patients received radio-chemotherapy. We compared craniospinal irradiation (CSI) dose, total irradiation dose on tumor bed and incidence of CSI between two groups.

Results: There were 21 male and 10 female patients, with a mean age of 19.3 years. Solitary tumors were found in 26 cases (83.9%), multiple tumors in 5 cases (16.1%). All patients were survived. The average CSI dose in radiotherapy alone group was 18.88±6.18 Gy and that of radio-chemotherapy group was 13.25±9.54 Gy. CSI dose in radiotherapy alone group was higher than that of radio-chemotherapy group (P=0.002). The average total radiation dose in radiotherapy alone group was 38.98±2.71 Gy and that of radio-chemotherapy group was 33.87±5.55 Gy. The total irradiation dose in radiotherapy alone group was also higher than that of radio-chemotherapy group (P=0.001). The incidence of CSI was higher in radiotherapy alone group (P＜0.05).

Conclusion: We discovered that there was a significant reduction of radiation dose in radio- chemotherapy group. It suggested that we could reduce the radiation dose in treatment of intracranial germinoma when we combine chemotherapy with radiation therapy, which could reduce the side effects of radiation.