Optimal Treatment for Intracranial Germinoma: Can We Lower Radiation Dose Without Chemotherapy?

Sang Hue Yen, Yi Wei Chen, Pin I. Huang, Tai-Tong Wong, Donald Ming Tak Ho, Kai Ping Chang, Muh Lii Liang, Shih Hwa Chiou, Yi Yen Lee, Hsin Hung Chen

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: To review the effectiveness of reduced-dose and restricted-volume radiation-only therapy in the treatment of intracranial germinoma and to assess the feasibility of reducing or eliminating the use of chemotherapy. Methods and Materials: Between January 1996 and March 2007, a retrospective analysis was performed that included 38 patients who received either reduced radiation alone (30 Gy for 26 patients) or reduced radiation with chemotherapy (n = 12 patients). All 38 patients received extended focal (including whole-ventricle) irradiation and were followed up until February 2008. Overall survival (OS) and relapse-free survival (RFS) rates were calculated. Variables associated with survival were evaluated by univariate Cox proportional hazards regression. Results: Median follow-up was 62.4 months (range, 10.1-142.5 months). The total 5-year OS rate was 93.7%. The 5-year OS and RFS rates for patients receiving radiation only were 100% and 96.2%, respectively. The rates for those receiving radiation plus chemotherapy were 83.3 % and 91.7%, respectively (not statistically significant). No predictive factor was significantly associated with the OS or RFS rate. Chemotherapy had no significant effect on survival but was associated with a higher incidence of treatment-related toxicity. Conclusions: A further decrease in the radiation dose to 30 Gy with whole-ventricle irradiation is sufficient to treat selected patients with intracranial germinoma. Wide-field irradiation or chemotherapy should be avoided as these methods are unnecessary. Thus, reduction of the radiation dose to 30 Gy may be feasible, even without chemotherapy.

Original languageEnglish
Pages (from-to)980-987
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume77
Issue number4
DOIs
Publication statusPublished - Jul 15 2010
Externally publishedYes

Fingerprint

Germinoma
chemotherapy
Radiation
Drug Therapy
dosage
radiation
Survival Rate
Survival
Recurrence
Therapeutics
irradiation
Radiotherapy
toxicity
hazards
regression analysis
therapy
Incidence
incidence

Keywords

  • Complication
  • Craniospinal irradiation
  • Germinoma
  • Radiotherapy
  • Whole-ventricle irradiation

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Optimal Treatment for Intracranial Germinoma : Can We Lower Radiation Dose Without Chemotherapy? / Yen, Sang Hue; Chen, Yi Wei; Huang, Pin I.; Wong, Tai-Tong; Ho, Donald Ming Tak; Chang, Kai Ping; Liang, Muh Lii; Chiou, Shih Hwa; Lee, Yi Yen; Chen, Hsin Hung.

In: International Journal of Radiation Oncology Biology Physics, Vol. 77, No. 4, 15.07.2010, p. 980-987.

Research output: Contribution to journalArticle

Yen, Sang Hue ; Chen, Yi Wei ; Huang, Pin I. ; Wong, Tai-Tong ; Ho, Donald Ming Tak ; Chang, Kai Ping ; Liang, Muh Lii ; Chiou, Shih Hwa ; Lee, Yi Yen ; Chen, Hsin Hung. / Optimal Treatment for Intracranial Germinoma : Can We Lower Radiation Dose Without Chemotherapy?. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 77, No. 4. pp. 980-987.
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abstract = "Purpose: To review the effectiveness of reduced-dose and restricted-volume radiation-only therapy in the treatment of intracranial germinoma and to assess the feasibility of reducing or eliminating the use of chemotherapy. Methods and Materials: Between January 1996 and March 2007, a retrospective analysis was performed that included 38 patients who received either reduced radiation alone (30 Gy for 26 patients) or reduced radiation with chemotherapy (n = 12 patients). All 38 patients received extended focal (including whole-ventricle) irradiation and were followed up until February 2008. Overall survival (OS) and relapse-free survival (RFS) rates were calculated. Variables associated with survival were evaluated by univariate Cox proportional hazards regression. Results: Median follow-up was 62.4 months (range, 10.1-142.5 months). The total 5-year OS rate was 93.7{\%}. The 5-year OS and RFS rates for patients receiving radiation only were 100{\%} and 96.2{\%}, respectively. The rates for those receiving radiation plus chemotherapy were 83.3 {\%} and 91.7{\%}, respectively (not statistically significant). No predictive factor was significantly associated with the OS or RFS rate. Chemotherapy had no significant effect on survival but was associated with a higher incidence of treatment-related toxicity. Conclusions: A further decrease in the radiation dose to 30 Gy with whole-ventricle irradiation is sufficient to treat selected patients with intracranial germinoma. Wide-field irradiation or chemotherapy should be avoided as these methods are unnecessary. Thus, reduction of the radiation dose to 30 Gy may be feasible, even without chemotherapy.",
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AU - Chen, Yi Wei

AU - Huang, Pin I.

AU - Wong, Tai-Tong

AU - Ho, Donald Ming Tak

AU - Chang, Kai Ping

AU - Liang, Muh Lii

AU - Chiou, Shih Hwa

AU - Lee, Yi Yen

AU - Chen, Hsin Hung

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N2 - Purpose: To review the effectiveness of reduced-dose and restricted-volume radiation-only therapy in the treatment of intracranial germinoma and to assess the feasibility of reducing or eliminating the use of chemotherapy. Methods and Materials: Between January 1996 and March 2007, a retrospective analysis was performed that included 38 patients who received either reduced radiation alone (30 Gy for 26 patients) or reduced radiation with chemotherapy (n = 12 patients). All 38 patients received extended focal (including whole-ventricle) irradiation and were followed up until February 2008. Overall survival (OS) and relapse-free survival (RFS) rates were calculated. Variables associated with survival were evaluated by univariate Cox proportional hazards regression. Results: Median follow-up was 62.4 months (range, 10.1-142.5 months). The total 5-year OS rate was 93.7%. The 5-year OS and RFS rates for patients receiving radiation only were 100% and 96.2%, respectively. The rates for those receiving radiation plus chemotherapy were 83.3 % and 91.7%, respectively (not statistically significant). No predictive factor was significantly associated with the OS or RFS rate. Chemotherapy had no significant effect on survival but was associated with a higher incidence of treatment-related toxicity. Conclusions: A further decrease in the radiation dose to 30 Gy with whole-ventricle irradiation is sufficient to treat selected patients with intracranial germinoma. Wide-field irradiation or chemotherapy should be avoided as these methods are unnecessary. Thus, reduction of the radiation dose to 30 Gy may be feasible, even without chemotherapy.

AB - Purpose: To review the effectiveness of reduced-dose and restricted-volume radiation-only therapy in the treatment of intracranial germinoma and to assess the feasibility of reducing or eliminating the use of chemotherapy. Methods and Materials: Between January 1996 and March 2007, a retrospective analysis was performed that included 38 patients who received either reduced radiation alone (30 Gy for 26 patients) or reduced radiation with chemotherapy (n = 12 patients). All 38 patients received extended focal (including whole-ventricle) irradiation and were followed up until February 2008. Overall survival (OS) and relapse-free survival (RFS) rates were calculated. Variables associated with survival were evaluated by univariate Cox proportional hazards regression. Results: Median follow-up was 62.4 months (range, 10.1-142.5 months). The total 5-year OS rate was 93.7%. The 5-year OS and RFS rates for patients receiving radiation only were 100% and 96.2%, respectively. The rates for those receiving radiation plus chemotherapy were 83.3 % and 91.7%, respectively (not statistically significant). No predictive factor was significantly associated with the OS or RFS rate. Chemotherapy had no significant effect on survival but was associated with a higher incidence of treatment-related toxicity. Conclusions: A further decrease in the radiation dose to 30 Gy with whole-ventricle irradiation is sufficient to treat selected patients with intracranial germinoma. Wide-field irradiation or chemotherapy should be avoided as these methods are unnecessary. Thus, reduction of the radiation dose to 30 Gy may be feasible, even without chemotherapy.

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KW - Radiotherapy

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