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Treatment strategy for intracranial primary pure germinoma

Authors
 Kyu-Won Shim ; Eun Kyung Park ; Dong-Seok Kim ; Joong-Uhn Choi ; Jaeho Cho ; Chang-Ok Suh ; Yoon-Ho Lee 
Citation
 Childs Nervous System, Vol.29(2) : 239~248, 2013 
Journal Title
 Childs Nervous System 
ISSN
 0256-7040 
Issue Date
2013
Abstract
OBJECT: This prospective randomized clinical study will address the efficacy of radiation (RT)-alone and combined with pre-RT chemotherapy (CTX) treatments and propose the novel standard treatment strategy for intracranial primary pure germinoma. MATERIALS AND METHODS: Between 2005 and 2008, there were 54 patients diagnosed with intracranial primary pure germinomas in a single institute. Twenty-eight patients were enrolled. The mean age of the patients was 16.2 years (range 6-31 years). There were 19 men and 9 women (men/women ratio = 2.1:1). There were 21 patients with solitary tumors and 7 with multiple tumors. These patients were randomized as RT-only treatment group (11 solitary and 3 multiple tumors) and combined (10 solitary and 4 multiple tumors, neo-adjuvant CTX followed by response-adapted RT) treatment group. The follow-up period for RT only group has a median of 58 months (mean 58.2 months, range 41-82 months), and for combine therapy group, the median was 68.5 months (mean 67.8 months, range 41-88 months). All 14 patients in the RT-only group showed complete response (CR) and no recurrence. Eleven patients in the combined group had CR and three patients had partial response after neo-adjuvant CTX. All patients responded to RT as CR without recurrence. At the time of analysis, all 28 patients were alive without evidence of disease. CONCLUSION: Neo-adjuvant CTX for localized germinomas seems to be unnecessary as a method to reduce radiation dose in our RT protocol. However, the effective control of multifocal or disseminated germinoma can be achieved by neo-adjuvant CTX followed by response-adapted reduced dose RT.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86276
DOI
10.1007/s00381-012-1902-x
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Neurosurgery
1. 연구논문 > 1. College of Medicine > Dept. of Radiation Oncology
Yonsei Authors
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Link
 http://link.springer.com/article/10.1007%2Fs00381-012-1902-x
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