Therapy outcomes of intracranial germinoma: a retrospective evaluation of 170 sufferers from a single establishment.
J Most cancers Res Clin Oncol. 2018 Sep 12;:
Authors: Lian X, Hou X, Yan J, Solar S, Miao Z, Liu Z, Wang W, Shen J, Shen J, Hu Okay, Zhang F
PURPOSE: To carry out a retrospective evaluation of sufferers with intracranial germinoma handled in our division to judge remedy outcomes and decide optimum remedy methods.
METHODS: We reviewed the remedy outcomes of 170 sufferers with intracranial germinoma who had been handled in our division from January 1996 to January 2017. The median affected person age was 15 years outdated. Among the many sufferers, 56 (33%) had been pathologically identified, and 114 (67%) had been identified clinically. Varied radiation fields and doses had been used. Cerebrospinal fluid (CSF) and serum beta-human chorionic gonadotropin (?-HCG) ranges had been examined earlier than remedy in 114 sufferers. Endocrinological analysis was carried out in 141 sufferers earlier than and after remedy. A complete of 38 sufferers acquired chemotherapy previous to radiotherapy (RT). The median follow-up time was 64.5 months (vary Four-260.5 months).
RESULTS: The 5- and 10-year total survival (OS) charges had been 94.5% and 91.three%, respectively. The relapse-free survival (RFS) charges at 5- and 10-years had been 91.9% and 78.1%, respectively. Relapses occurred in 18 sufferers inside 6 months-10 years. The spinal twine metastasis price was three.Four% in sufferers with a localized lesion who didn’t obtain spinal twine irradiation and 16.7% in sufferers with bifocal illness who had been handled utilizing entire ventricular irradiation (WVI) or entire mind radiotherapy (WBRT). Therapy failure didn’t happen in sufferers receiving chemoradiotherapy or in sufferers receiving three-dimensional conformal radiation remedy (3D-CRT)/intensity-modulated radiation remedy (IMRT). The RFS price didn’t have a statistically vital correlation with the CSF/serum ?-HCG stage. After RT, 19.1% of the sufferers developed newly impaired pituitary operate and required hormone substitute remedy.
CONCLUSIONS: WVI or WBRT+?major enhance (PB) is a adequate irradiation area for localized intracranial germinoma, whereas sufferers with bifocal illness ought to bear craniospinal irradiation (CSI), particularly when handled with RT alone. CSF ?-HCG shouldn’t be a prognostic marker for intracranial germinomas. The remedy outcomes of chemotherapy adopted by reduced-dose RT are akin to these of RT alone. IMRT is beneficial for intracranial germinoma to enhance the goal quantity accuracy and reduce the issues of RT.
PMID: 30209611 [PubMed – as supplied by publisher]