Improved Outcome of Central Nervous System Germ Cell Tumors: Implications for the Role of Risk-adapted Intensive Chemotherapy
Keon Hee Yoo,Soo Hyun Lee,Jeehun Lee,Ki Woong Sung,Hye Lim Jung,Hong Hoe Koo,Do Hoon Lim,Jong Hyun Kim,Hyung Jin Shin +8 more
TLDR
It is suggested that risk-adapted intensive chemotherapy may improve the outcome of patients with malignant CNS-GCTs and should be considered as a first line treatment according to the clinical requirements.Abstract:
To determine the impact of treatment protocols on the outcome of central nervous system germ cell tumors (CNS-GCTs), we reviewed the medical records of 53 patients who received front-line chemotherapy from September 1997 to September 2006. Pure germinoma, normal alpha-fetoprotein level and beta-human chorionic gonadotropin level <50 mIU/mL were regarded as low-risk features and the others as high-risk. Patients from different time periods were divided into 3 groups according to the chemotherapy protocols. Group 1 (n=19) received 4 cycles of chemotherapy comprising cisplatin, etoposide and bleomycin. Group 2 (n=16) and group 3 (n=18) received 4 cycles of chemotherapy with cisplatin, etoposide, cyclophosphamide and vincristine in the former and with carboplatin, etoposide, cyclophosphamide and bleomycin in the latter. In group 2 and group 3, high-risk patients received double doses of cisplatin, carboplatin and cyclophosphamide. Radiotherapy was given after chemotherapy according to the clinical requirements. The event-free survivals of groups 1, 2, and 3 were 67.0%, 93.8%, and 100%, respectively (group 1 vs. 2, P=0.06; group 2 vs. 3, P=0.29; group 1 vs. 3, P=0.02). Our data suggest that risk-adapted intensive chemotherapy may improve the outcome of patients with malignant CNS-GCTs.read more
Citations
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Journal ArticleDOI
Treatment strategy for intracranial primary pure germinoma
TL;DR: Neo-adjuvant CTX for localized germinomas seems to be unnecessary as a method to reduce radiation dose in the RT protocol, however, the effective control of multifocal or disseminated germinoma can be achieved by neo- adjuvantCTX followed by response-adapted reduced dose RT.
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Neuroendoscopic biopsy of pediatric brain tumors with small ventricle
TL;DR: Navigational tracking improved the accuracy of the neuroendoscopic approach and minimized brain trauma in pediatric patients without hydrocephalus, and the absence of ventriculomegaly in patients with brain tumor may not serve as a contraindication to neuro endoscopic tumor biopsy.
Journal ArticleDOI
Germinoma with involvement of midline and off-midline intracranial structures.
Monica Graciela Loto,Karina Danilowicz,Santiago González Abbati,Rafael Torino,Alejandro Misiunas +4 more
TL;DR: Germinoma must be considered in patients with insipidus diabetes with a sellar mass with thickening of pituitary stalk; and ectopic germinomamust be suspected in patientsWith slowly progressive hemiparesis with cerebral hemiatrophy, even with a rare condition, colocalization of midline and off-midline germinomas must be suspected.
Journal ArticleDOI
Responses and adverse effects of carboplatin-based chemotherapy for pediatric intracranial germ cell tumors.
Suntae Ji,Hee Won Chueh,Ju Youn Kim,Su Jin Lim,Eun Joo Cho,Soo Hyun Lee,Keon Hee Yoo,Ki Woong Sung,Hong Hoe Koo +8 more
TL;DR: The current carboplatin-based chemotherapy protocol is safe and effective for the treatment of pediatric patients with IC-GCTs and it is concluded that no lethal hematological complications were associated with this treatment.
Book ChapterDOI
Pediatric Brain Tumors: Viewpoint—Chemotherapy
TL;DR: Stereotactic radiosurgery (SRS) has advantages over other therapeutic modalities in certain settings and has a role in the management of pediatric brain tumors, however, that role is limited by the propensity of pediatric neural tumors to disseminate along cerebrospinal fluid pathways or to infiltrate surrounding brain.
References
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Journal ArticleDOI
Treatment of a primary intracranial germ cell tumor with systemic chemotherapy
Jeffrey J. Kirshner,Jeffrey J. Kirshner,Sandra J. Ginsberg,Alicia V. Fitzpatrick,Robert L. Comis +4 more
TL;DR: It is concluded that systemic chemotherapy may be beneficial in certain cases of CNS germ cell neoplasms.
Journal Article
Radiotherapy for intracranial germinoma
TL;DR: The technology of radiotherapy is progressing, so low side effect and high cure rate may be realized and some problems and standards of radi therapy for intracranial germinoma was more clear.