Extended focal radiotherapy of 30 Gy alone for intracranial synchronous bifocal germinoma

A single institute experience

Pin I. Huang, Yi Wei Chen, Tai-Tong Wong, Yi Yen Lee, Kai Ping Chang, Wan Yuo Guo, Feng Chi Chang, Muh Lii Liang, Hsin Hung Chen, Shi Hwa Chiou, Sang Hue Yen

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objects: To evaluate the disease characteristics and treatment outcomes for patients with intracranial synchronous bifocal germinomas treated with extended focal irradiation alone. Methods: Between January 1996 and March 2007, seven patients (three males and four females) with intracranial synchronous bifocal germinomas treated at Taipei Veterans General Hospital were reviewed. The median age at diagnosis was 14 years (range, 11-28 years). Four patients had surgery before radiotherapy. All patients underwent extended focal irradiation encompassing the whole ventricle system with a total radiation dose of 30 Gy (2 Gy daily). No patient received scheduled systemic chemotherapy before or after radiotherapy. Disease characteristics, treatment outcomes, and the impact of lesion numbers (single vs. bifocal) on survivals were investigated. Results: With a median follow-up time of 49 months (range, 20-66 months), the 2- and 5-year survival rates were both 100%. After treatment, all patients had good performance without recurrence. No severe complication was observed. In comparison, the overall survival (OS, p=0.475) and the disease-free survival (DFS, p=0.537) rates were not significantly different between bifocal- and single-lesion groups. Lesion numbers did not affect both OS and DFS. In addition, the incidence of neuraxial seeding was not higher in patients with bifocal germinomas as compared to those with single lesion. Conclusions: Intracranial germinomas are extremely radiosensitive. Young patients with synchronous bifocal germinomas could be successfully treated with extended focal 30-Gy radiotherapy alone. The therapeutic advantage using this regimen needs to be further evaluated with larger sample size and longer follow-up time.

Original languageEnglish
Pages (from-to)1315-1321
Number of pages7
JournalChild's Nervous System
Volume24
Issue number11
DOIs
Publication statusPublished - Jun 26 2008
Externally publishedYes

Fingerprint

Germinoma
Radiotherapy
Veterans Hospitals
Survival
General Hospitals
Sample Size
Disease-Free Survival
Survival Rate
Radiation
Recurrence
Drug Therapy

Keywords

  • Bifocal
  • Germinoma
  • Intracranial
  • Radiotherapy
  • Whole ventricle irradiation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Extended focal radiotherapy of 30 Gy alone for intracranial synchronous bifocal germinoma : A single institute experience. / Huang, Pin I.; Chen, Yi Wei; Wong, Tai-Tong; Lee, Yi Yen; Chang, Kai Ping; Guo, Wan Yuo; Chang, Feng Chi; Liang, Muh Lii; Chen, Hsin Hung; Chiou, Shi Hwa; Yen, Sang Hue.

In: Child's Nervous System, Vol. 24, No. 11, 26.06.2008, p. 1315-1321.

Research output: Contribution to journalArticle

Huang, PI, Chen, YW, Wong, T-T, Lee, YY, Chang, KP, Guo, WY, Chang, FC, Liang, ML, Chen, HH, Chiou, SH & Yen, SH 2008, 'Extended focal radiotherapy of 30 Gy alone for intracranial synchronous bifocal germinoma: A single institute experience', Child's Nervous System, vol. 24, no. 11, pp. 1315-1321. https://doi.org/10.1007/s00381-008-0648-y
Huang, Pin I. ; Chen, Yi Wei ; Wong, Tai-Tong ; Lee, Yi Yen ; Chang, Kai Ping ; Guo, Wan Yuo ; Chang, Feng Chi ; Liang, Muh Lii ; Chen, Hsin Hung ; Chiou, Shi Hwa ; Yen, Sang Hue. / Extended focal radiotherapy of 30 Gy alone for intracranial synchronous bifocal germinoma : A single institute experience. In: Child's Nervous System. 2008 ; Vol. 24, No. 11. pp. 1315-1321.
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T1 - Extended focal radiotherapy of 30 Gy alone for intracranial synchronous bifocal germinoma

T2 - A single institute experience

AU - Huang, Pin I.

AU - Chen, Yi Wei

AU - Wong, Tai-Tong

AU - Lee, Yi Yen

AU - Chang, Kai Ping

AU - Guo, Wan Yuo

AU - Chang, Feng Chi

AU - Liang, Muh Lii

AU - Chen, Hsin Hung

AU - Chiou, Shi Hwa

AU - Yen, Sang Hue

PY - 2008/6/26

Y1 - 2008/6/26

N2 - Objects: To evaluate the disease characteristics and treatment outcomes for patients with intracranial synchronous bifocal germinomas treated with extended focal irradiation alone. Methods: Between January 1996 and March 2007, seven patients (three males and four females) with intracranial synchronous bifocal germinomas treated at Taipei Veterans General Hospital were reviewed. The median age at diagnosis was 14 years (range, 11-28 years). Four patients had surgery before radiotherapy. All patients underwent extended focal irradiation encompassing the whole ventricle system with a total radiation dose of 30 Gy (2 Gy daily). No patient received scheduled systemic chemotherapy before or after radiotherapy. Disease characteristics, treatment outcomes, and the impact of lesion numbers (single vs. bifocal) on survivals were investigated. Results: With a median follow-up time of 49 months (range, 20-66 months), the 2- and 5-year survival rates were both 100%. After treatment, all patients had good performance without recurrence. No severe complication was observed. In comparison, the overall survival (OS, p=0.475) and the disease-free survival (DFS, p=0.537) rates were not significantly different between bifocal- and single-lesion groups. Lesion numbers did not affect both OS and DFS. In addition, the incidence of neuraxial seeding was not higher in patients with bifocal germinomas as compared to those with single lesion. Conclusions: Intracranial germinomas are extremely radiosensitive. Young patients with synchronous bifocal germinomas could be successfully treated with extended focal 30-Gy radiotherapy alone. The therapeutic advantage using this regimen needs to be further evaluated with larger sample size and longer follow-up time.

AB - Objects: To evaluate the disease characteristics and treatment outcomes for patients with intracranial synchronous bifocal germinomas treated with extended focal irradiation alone. Methods: Between January 1996 and March 2007, seven patients (three males and four females) with intracranial synchronous bifocal germinomas treated at Taipei Veterans General Hospital were reviewed. The median age at diagnosis was 14 years (range, 11-28 years). Four patients had surgery before radiotherapy. All patients underwent extended focal irradiation encompassing the whole ventricle system with a total radiation dose of 30 Gy (2 Gy daily). No patient received scheduled systemic chemotherapy before or after radiotherapy. Disease characteristics, treatment outcomes, and the impact of lesion numbers (single vs. bifocal) on survivals were investigated. Results: With a median follow-up time of 49 months (range, 20-66 months), the 2- and 5-year survival rates were both 100%. After treatment, all patients had good performance without recurrence. No severe complication was observed. In comparison, the overall survival (OS, p=0.475) and the disease-free survival (DFS, p=0.537) rates were not significantly different between bifocal- and single-lesion groups. Lesion numbers did not affect both OS and DFS. In addition, the incidence of neuraxial seeding was not higher in patients with bifocal germinomas as compared to those with single lesion. Conclusions: Intracranial germinomas are extremely radiosensitive. Young patients with synchronous bifocal germinomas could be successfully treated with extended focal 30-Gy radiotherapy alone. The therapeutic advantage using this regimen needs to be further evaluated with larger sample size and longer follow-up time.

KW - Bifocal

KW - Germinoma

KW - Intracranial

KW - Radiotherapy

KW - Whole ventricle irradiation

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