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Treatment failure in intracranial primary germinomas

Authors
 Kyu-Won Shim  ;  Tae-Gon Kim  ;  Dong-Seok Kim  ;  Jung-Hee Kim  ;  Joong-Uhn Choi  ;  Chul-Joo Yoo  ;  Jae-Ho Cho  ;  Chang-Ok Suh 
Citation
 CHILDS NERVOUS SYSTEM, Vol.23(10) : 1155-1161, 2007 
Journal Title
 CHILDS NERVOUS SYSTEM 
ISSN
 0256-7040 
Issue Date
2007
Abstract
OBJECT: A radiation dose of 40-50 Gy is able to produce a cure rate of more than 90% in intracranial pure germinoma. However, many attempts have been made to reduce the dose and volume of radiation without compromising the disease control rate because of the toxicity of irradiation. This retrospective study is intended to provide the physician with an appropriate therapeutic strategy. MATERIALS AND METHODS: We reviewed a series of 10 recurrent germinomas among 117 germinomas diagnosed histologically or clinically between 1979 and 2002. These patients involved underwent three different treatment modalities; radiation alone (N = 71), chemotherapy alone (N = 9), and combined therapy (N = 37). The 10-year overall and relapse-free survival rates were 97 and 93% in the radiation alone group, 89 and 67% in the chemotherapy alone group, and 92 and 92% in the combined therapy group, respectively. As expected, both radiation therapy and combined therapy were effective in controlling the disease. Tumor recurrence was closely related to the volume of radiation but not to the dose of radiation. If the tumor bed and craniospinal axis were fully covered, the radiation dose might be reduced. Chemotherapy alone showed earlier recurrence and a higher tumor recurrence rate. In the case of combined therapy, chemotherapy was useful in reducing the radiation dose but revealed some toxicity (death of two patients). CONCLUSIONS: The investigation of a possible further dose reduction seems worthwhile. Radiation therapy alone with a dose of less than 40 Gy should be compared with ongoing chemotherapeutic protocols combined with low-dose irradiation.
Full Text
http://link.springer.com/article/10.1007%2Fs00381-007-0394-6
DOI
10.1007/s00381-007-0394-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Jung Hee(김정희)
Kim, Tae Gon(김태곤)
Suh, Chang Ok(서창옥)
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
Choi, Joong Uhn(최중언)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95844
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