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Treatment strategies for initially disseminated intracranial germinomas

Experiences at a single institute

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Abstract

Purpose

Initially disseminated intracranial germinomas (IDIGs) can be observed in pre-adult and adolescent brain tumor patients. However, the disease prognosis is undetermined, and the method of optimal treatment remains controversial.

Methods

From January 1990 to January 2011, data on 91 intracranial germinoma patients (≤20 years old) were gathered from the Pediatric Brain Tumor database at Taipei Veterans General Hospital. A total of seven patients with a median age of 17.0 years had IDIGs (lesion sites >2), including IDIGs in the ventricular system or the spinal column. Craniospinal irradiation (CSI) plus a primary or metastatic boost was the mainstay strategy for radiotherapy. Six out of a total of seven patients (85.7%) also received systemic chemotherapy (CHT) after radiotherapy. Survivals rates between IDIGs and patients without dissemination were estimated using the Kaplan–Meier method.

Results

The median follow-up time for all seven patients was 67.5 months (range, 10.3–142.3 months). None of the IDIG patients experienced a recurrence or mortality after the completion of treatment. The 5- and 10-year disease-free survival (DFS) between IDIG and non-dissemination patients were 100%, 100%, 93.0% and 78.6%, respectively (p = 0.339). The 5- and 10-year overall survival (OS) between IDIGs and non-dissemination cases were 100%, 100%, 93.7% and 89.4%, respectively (p = 0.473).

Conclusions

IDIG patients did not show reduced survival compared to non-dissemination patients if optimal radiotherapy and chemotherapy were used together.

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Acknowledgements

This work was supported by grants from Taipei Veterans General Hospital (VGH98B1-006, V100B-022 and V101B-001); National Science Council (NSC-100-2314-B-075-069), Department of Health, R.O.C. (DOH100-TD-C-111-007) and the Charity Foundation of JUT Land Development Group, Taiwan

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Radiation Oncology, Cancer Center, Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan

    Yi-Wei Chen, Pin-I Huang, Yu-Wen Hu, Cheng-Ying Shiau & Sang-Hue Yen

  2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

    Yi-Wei Chen, Pin-I Huang & Yi-Yen Lee

  3. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Yi-Wei Chen, Pin-I Huang, Donald Ming-Tak Ho, Wan-Yuo Guo, Feng-Chi Chang, Yi-Yen Lee & Tai-Tong Wong

  4. Department of Pathology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Donald Ming-Tak Ho

  5. Department of Pediatrics, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Kai-Ping Chang

  6. Department of Radiology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Wan-Yuo Guo & Feng-Chi Chang

  7. Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Yi-Yen Lee & Tai-Tong Wong

  8. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan

    Sang-Hue Yen

Authors
  1. Yi-Wei Chen
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  2. Pin-I Huang
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  3. Yu-Wen Hu
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  4. Donald Ming-Tak Ho
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  6. Wan-Yuo Guo
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  7. Feng-Chi Chang
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  8. Yi-Yen Lee
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  9. Cheng-Ying Shiau
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  10. Tai-Tong Wong
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  11. Sang-Hue Yen
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Corresponding authors

Correspondence to Tai-Tong Wong or Sang-Hue Yen.

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Chen, YW., Huang, PI., Hu, YW. et al. Treatment strategies for initially disseminated intracranial germinomas. Childs Nerv Syst 28, 557–563 (2012). https://doi.org/10.1007/s00381-012-1683-2

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  • DOI: https://doi.org/10.1007/s00381-012-1683-2

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