Change in treatment strategy for intracranial germinoma

Long-term follow-up experience at a single institute

Yi Wei Chen, Pin I. Huang, Donald Ming Tak Ho, Yu Wen Hu, Kai Ping Chang, Shih Hwa Chiou, Wan Yuo Guo, Feng Chi Chang, Muh Lii Liang, Yi Yen Lee, Hsin Hung Chen, Ting Rong Hsu, Shih Chieh Lin, Tai-Tong Wong, Sang Hue Yen

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

BACKGROUND: Previous intracranial germinoma (IG) studies have investigated the effect of different radiotherapy (RT) volumes and the necessity for adjunctive chemotherapy, but there is currently no consensus on the best treatment for this tumor. METHODS: From January 1989 to December 2009, 80 IG patients (≤20 years old) were treated with various RT regimens. Of them, 14 patients had craniospinal irradiation (CSI) + primary boost (PB); 8 patients had whole-brain irradiation (WBI) + PB; 31 patients had whole ventricular irradiation (WVI) + PB; and 27 patients had focal RT only. Twenty-nine patients (36.2%) also received systemic chemotherapy (CHT). Survival was estimated by the Kaplan-Meier method and variables affecting survival were analyzed by the Cox proportional hazard model. RESULTS: Eleven patients (13.8%) developed local recurrence or dissemination after treatment, and 10 of these patients were in the focal RT group. The 5-year relapse-free survival (RFS) for the CSI, WBI, WVI, and focal RT patients were 100%, 85.7%, 100%, and 84.6%, respectively (P =.001). The 5-year overall survival (OS) for CSI, WBI, WVI, and focal RT patients was 100%, 83.3%, 100%, and 87.9%, respectively (P =.125). Focal irradiation (P =.02) and initial use of CHT (P =.021) were negatively associated with RFS. CONCLUSIONS: Focal RT plus CHT were associated with inferior control of IG and a higher incidence of CHT-related toxicities. Adjustment of the radiation volume to the whole ventricular system without CHT is sufficient for treatment of nondisseminated IGs, even with lower primary RT doses (<36 Gy). Cancer 2011.

Original languageEnglish
Pages (from-to)2752-2762
Number of pages11
JournalCancer
Volume118
Issue number10
DOIs
Publication statusPublished - May 15 2012
Externally publishedYes

Fingerprint

Germinoma
Radiotherapy
Craniospinal Irradiation
Drug Therapy
Survival
Therapeutics
Recurrence
Brain
Proportional Hazards Models
Neoplasms

Keywords

  • complication
  • craniospinal irradiation
  • germinoma
  • radiotherapy
  • whole ventricular irradiation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Chen, Y. W., Huang, P. I., Ho, D. M. T., Hu, Y. W., Chang, K. P., Chiou, S. H., ... Yen, S. H. (2012). Change in treatment strategy for intracranial germinoma: Long-term follow-up experience at a single institute. Cancer, 118(10), 2752-2762. https://doi.org/10.1002/cncr.26564

Change in treatment strategy for intracranial germinoma : Long-term follow-up experience at a single institute. / Chen, Yi Wei; Huang, Pin I.; Ho, Donald Ming Tak; Hu, Yu Wen; Chang, Kai Ping; Chiou, Shih Hwa; Guo, Wan Yuo; Chang, Feng Chi; Liang, Muh Lii; Lee, Yi Yen; Chen, Hsin Hung; Hsu, Ting Rong; Lin, Shih Chieh; Wong, Tai-Tong; Yen, Sang Hue.

In: Cancer, Vol. 118, No. 10, 15.05.2012, p. 2752-2762.

Research output: Contribution to journalArticle

Chen, YW, Huang, PI, Ho, DMT, Hu, YW, Chang, KP, Chiou, SH, Guo, WY, Chang, FC, Liang, ML, Lee, YY, Chen, HH, Hsu, TR, Lin, SC, Wong, T-T & Yen, SH 2012, 'Change in treatment strategy for intracranial germinoma: Long-term follow-up experience at a single institute', Cancer, vol. 118, no. 10, pp. 2752-2762. https://doi.org/10.1002/cncr.26564
Chen, Yi Wei ; Huang, Pin I. ; Ho, Donald Ming Tak ; Hu, Yu Wen ; Chang, Kai Ping ; Chiou, Shih Hwa ; Guo, Wan Yuo ; Chang, Feng Chi ; Liang, Muh Lii ; Lee, Yi Yen ; Chen, Hsin Hung ; Hsu, Ting Rong ; Lin, Shih Chieh ; Wong, Tai-Tong ; Yen, Sang Hue. / Change in treatment strategy for intracranial germinoma : Long-term follow-up experience at a single institute. In: Cancer. 2012 ; Vol. 118, No. 10. pp. 2752-2762.
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abstract = "BACKGROUND: Previous intracranial germinoma (IG) studies have investigated the effect of different radiotherapy (RT) volumes and the necessity for adjunctive chemotherapy, but there is currently no consensus on the best treatment for this tumor. METHODS: From January 1989 to December 2009, 80 IG patients (≤20 years old) were treated with various RT regimens. Of them, 14 patients had craniospinal irradiation (CSI) + primary boost (PB); 8 patients had whole-brain irradiation (WBI) + PB; 31 patients had whole ventricular irradiation (WVI) + PB; and 27 patients had focal RT only. Twenty-nine patients (36.2{\%}) also received systemic chemotherapy (CHT). Survival was estimated by the Kaplan-Meier method and variables affecting survival were analyzed by the Cox proportional hazard model. RESULTS: Eleven patients (13.8{\%}) developed local recurrence or dissemination after treatment, and 10 of these patients were in the focal RT group. The 5-year relapse-free survival (RFS) for the CSI, WBI, WVI, and focal RT patients were 100{\%}, 85.7{\%}, 100{\%}, and 84.6{\%}, respectively (P =.001). The 5-year overall survival (OS) for CSI, WBI, WVI, and focal RT patients was 100{\%}, 83.3{\%}, 100{\%}, and 87.9{\%}, respectively (P =.125). Focal irradiation (P =.02) and initial use of CHT (P =.021) were negatively associated with RFS. CONCLUSIONS: Focal RT plus CHT were associated with inferior control of IG and a higher incidence of CHT-related toxicities. Adjustment of the radiation volume to the whole ventricular system without CHT is sufficient for treatment of nondisseminated IGs, even with lower primary RT doses (<36 Gy). Cancer 2011.",
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T1 - Change in treatment strategy for intracranial germinoma

T2 - Long-term follow-up experience at a single institute

AU - Chen, Yi Wei

AU - Huang, Pin I.

AU - Ho, Donald Ming Tak

AU - Hu, Yu Wen

AU - Chang, Kai Ping

AU - Chiou, Shih Hwa

AU - Guo, Wan Yuo

AU - Chang, Feng Chi

AU - Liang, Muh Lii

AU - Lee, Yi Yen

AU - Chen, Hsin Hung

AU - Hsu, Ting Rong

AU - Lin, Shih Chieh

AU - Wong, Tai-Tong

AU - Yen, Sang Hue

PY - 2012/5/15

Y1 - 2012/5/15

N2 - BACKGROUND: Previous intracranial germinoma (IG) studies have investigated the effect of different radiotherapy (RT) volumes and the necessity for adjunctive chemotherapy, but there is currently no consensus on the best treatment for this tumor. METHODS: From January 1989 to December 2009, 80 IG patients (≤20 years old) were treated with various RT regimens. Of them, 14 patients had craniospinal irradiation (CSI) + primary boost (PB); 8 patients had whole-brain irradiation (WBI) + PB; 31 patients had whole ventricular irradiation (WVI) + PB; and 27 patients had focal RT only. Twenty-nine patients (36.2%) also received systemic chemotherapy (CHT). Survival was estimated by the Kaplan-Meier method and variables affecting survival were analyzed by the Cox proportional hazard model. RESULTS: Eleven patients (13.8%) developed local recurrence or dissemination after treatment, and 10 of these patients were in the focal RT group. The 5-year relapse-free survival (RFS) for the CSI, WBI, WVI, and focal RT patients were 100%, 85.7%, 100%, and 84.6%, respectively (P =.001). The 5-year overall survival (OS) for CSI, WBI, WVI, and focal RT patients was 100%, 83.3%, 100%, and 87.9%, respectively (P =.125). Focal irradiation (P =.02) and initial use of CHT (P =.021) were negatively associated with RFS. CONCLUSIONS: Focal RT plus CHT were associated with inferior control of IG and a higher incidence of CHT-related toxicities. Adjustment of the radiation volume to the whole ventricular system without CHT is sufficient for treatment of nondisseminated IGs, even with lower primary RT doses (<36 Gy). Cancer 2011.

AB - BACKGROUND: Previous intracranial germinoma (IG) studies have investigated the effect of different radiotherapy (RT) volumes and the necessity for adjunctive chemotherapy, but there is currently no consensus on the best treatment for this tumor. METHODS: From January 1989 to December 2009, 80 IG patients (≤20 years old) were treated with various RT regimens. Of them, 14 patients had craniospinal irradiation (CSI) + primary boost (PB); 8 patients had whole-brain irradiation (WBI) + PB; 31 patients had whole ventricular irradiation (WVI) + PB; and 27 patients had focal RT only. Twenty-nine patients (36.2%) also received systemic chemotherapy (CHT). Survival was estimated by the Kaplan-Meier method and variables affecting survival were analyzed by the Cox proportional hazard model. RESULTS: Eleven patients (13.8%) developed local recurrence or dissemination after treatment, and 10 of these patients were in the focal RT group. The 5-year relapse-free survival (RFS) for the CSI, WBI, WVI, and focal RT patients were 100%, 85.7%, 100%, and 84.6%, respectively (P =.001). The 5-year overall survival (OS) for CSI, WBI, WVI, and focal RT patients was 100%, 83.3%, 100%, and 87.9%, respectively (P =.125). Focal irradiation (P =.02) and initial use of CHT (P =.021) were negatively associated with RFS. CONCLUSIONS: Focal RT plus CHT were associated with inferior control of IG and a higher incidence of CHT-related toxicities. Adjustment of the radiation volume to the whole ventricular system without CHT is sufficient for treatment of nondisseminated IGs, even with lower primary RT doses (<36 Gy). Cancer 2011.

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KW - whole ventricular irradiation

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