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Treatment strategy for intracranial primary pure germinoma

 Kyu-Won Shim  ;  Eun Kyung Park  ;  Yoon-Ho Lee  ;  Chang-Ok Suh  ;  Jaeho Cho  ;  Joong-Uhn Choi  ;  Dong-Seok Kim 
 CHILDS NERVOUS SYSTEM, Vol.29(2) : 239-248, 2013 
Journal Title
Issue Date
Adolescent ; Adult ; Antineoplastic Agents/administration & dosage* ; Brain Neoplasms/drug therapy* ; Brain Neoplasms/pathology ; Brain Neoplasms/radiotherapy* ; Child ; Combined Modality Therapy/methods ; Female ; Follow-Up Studies ; Germinoma/drug therapy* ; Germinoma/pathology ; Germinoma/radiotherapy* ; Humans ; Male ; Treatment Outcome ; Young Adult
Germ cell tumor ; Germinoma ; Craniospinal irradiation ; Neo-adjuvant chemotherapy
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.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Park, Eun Kyung(박은경)
Suh, Chang Ok(서창옥)
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
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