Journal ArticleDOI
Treatment strategy for intracranial primary pure germinoma
TLDR
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.Abstract:
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. 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. 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.read more
Citations
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Journal ArticleDOI
Current Management of Intracranial Germ Cell Tumours.
A Bowzyk Al-Naeeb,Matthew J. Murray,Gail Horan,Fiona Harris,Rolf D. Kortmann,James Nicholson,TV Ajithkumar +6 more
TL;DR: Current research generally focuses on reducing treatment intensity, particularly the dose and volume of radiotherapy, in order to minimise the risks of late sequelae while maintaining high cure rates in icGCTs.
Journal ArticleDOI
Understanding the Treatment Strategies of Intracranial Germ Cell Tumors: Focusing on Radiotherapy.
Joo-Young Kim,Jeong-Hoon Park +1 more
TL;DR: It is tested whether whole ventricular irradiation can replace craniospinal irradiation in intermediate risk group of NGGCT to minimize radiation-related late toxicity in the recent studies.
Journal ArticleDOI
Differential dosimetric benefit of proton beam therapy over intensity modulated radiotherapy for a variety of targets in patients with intracranial germ cell tumors
TL;DR: PSPT and SSPT provide superior target volume coverage and saved more normal tissue compared with IMRT for ICGCTs in various locations and future studies should assess whether the extent of normal tissue saved has clinical benefits in children with ICG CTs.
Journal ArticleDOI
Treatment outcomes of intracranial germinoma: a retrospective analysis of 170 patients from a single institution
Xin Lian,Xiaorong Hou,Junfang Yan,Shuai Sun,Zheng Miao,Zhikai Liu,Weiping Wang,Jing Shen,Jie Shen,Ke Hu,Fuquan Zhang +10 more
TL;DR: WVI or WBRT+ primary boost (PB) is a sufficient irradiation field for localized intracranial germinoma, while patients with bifocal disease should undergo craniospinal irradiation (CSI), especially when treated with RT alone.
Journal ArticleDOI
Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma: Prospective multicenter cohort study.
Dong Soo Lee,Do Hoon Lim,Il Han Kim,Joo Young Kim,Jung Woo Han,Keon Hee Yoo,Kyung Duk Park,Hyeon Jin Park,Nack Gyun Chung,Chang Ok Suh,Dong Seok Kim +10 more
TL;DR: Currently used upfront chemotherapy followed by reduced-dose, reduced-volume RT appears acceptable, when whole-ventricle RT for pineal or suprasellar tumors and, at minimum, whole-brain RT for basal ganglia/thalamus lesions are applied.
References
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Intracranial germ-cell tumors in children
Harold J. Hoffman,Hiroshi Otsubo,E B Hendrick,Robin P. Humphreys,James M. Drake,L. E. Becker,Mark T. Greenberg,D Jenkin +7 more
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Journal ArticleDOI
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Journal ArticleDOI
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Michael Bamberg,R.-D. Kortmann,Gabriele Calaminus,Gerd Becker,Christoph Meisner,Dieter Harms,Ulrich Göbel +6 more
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Journal ArticleDOI
Midline pineal tumors and suprasellar germinomas: highly curable by irradiation.
TL;DR: Sixty-one patients with midline pineal tumors and 16 patients with suprasellar germinomas were treated with surgical decompression and relatively high-dose radiotherapy of the primary site, and there were no long-term complications.
Journal ArticleDOI
Neoadjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system.
TL;DR: Patients who have complete responses to neoadjuvant chemotherapy tolerate a significant radiotherapy dose reduction without compromising long-term survival, thereby allowing a reduction of some of the late effects of therapeutic radiation.