Treatment results and prognostic factors for intracranial nongerminomatous germ cell tumors

single institute experience

I. Chun Lai, Tai-Tong Wong, Cheng Ying Shiau, Yu Wen Hu, Donald Ming Tak Ho, Kai Ping Chang, Wan Yuo Guo, Feng Chi Chang, Muh Lii Liang, Yi Yen Lee, Hsin Hung Chen, Sang Hue Yen, Yi Wei Chen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: This study aimed to evaluate the treatment of intracranial nongerminomatous germ cell tumors (NGGCT) and to identify the prognostic factors for survival.Methods: Thirty-nine patients with nondisseminated NGGCTs, excluding those with pure mature teratomas, were treated between January 1985 and December 2010. Twenty-four patients received gross total or partial removal, 11 had excision biopsies, and 4 had no surgery. Radiotherapy was given postoperatively or definitively with a median tumor bed dose of 54 Gy (range 30–54) with or without craniospinal irradiation. All patients received ten cycles of adjuvant chemotherapy, vinblastine, bleomycin, etoposide, and cisplatin after radiotherapy, except for one with mixed anaplastic astrocytoma component who received oral temozolomide. Survival and prognostic factors were estimated by the Kaplan–Meier method and log-rank tests, respectively.Results: After a median follow-up of 77.7 months (range 14–336), the 6-year overall survival (OS) and progression-free survival (PFS) were 74.4 and 79.5 %, respectively. Inferior PFS was associated with lesions in the suprasellar region (p = 0.017), poor pathological features (p = 0.048), and with poor image (p < 0.0001) and tumor marker (TM) response (p = 0.003) to irradiation. Decreased OS was associated with lesions in the suprasellar region (p = 0.026) and with poor image (p < 0.0001) and TM response (p = 0.027) to irradiation. Neither the extent of surgery nor the radiation field was found to significantly influence survival.Conclusions: By our multimodality approach, patients achieved comparable outcomes. Other than poor pathological features, patients with poor responses to radiotherapy are prone to early recurrence and inferior survival. These patients should be focused for more intensive adjuvant treatment.

Original languageEnglish
Pages (from-to)683-691
Number of pages9
JournalChild's Nervous System
Volume31
Issue number5
DOIs
Publication statusPublished - May 1 2015
Externally publishedYes

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Germ Cell and Embryonal Neoplasms
Survival
Radiotherapy
temozolomide
Tumor Biomarkers
Disease-Free Survival
Therapeutics
Craniospinal Irradiation
Vinblastine
Teratoma
Bleomycin
Astrocytoma
Etoposide
Adjuvant Chemotherapy
Cisplatin
Radiation
Biopsy
Recurrence
Neoplasms

Keywords

  • Chemotherapy
  • Nongerminomatous germ cell tumor
  • Prognosis
  • Radiotherapy
  • Response
  • Surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Treatment results and prognostic factors for intracranial nongerminomatous germ cell tumors : single institute experience. / Lai, I. Chun; Wong, Tai-Tong; Shiau, Cheng Ying; Hu, Yu Wen; Ho, Donald Ming Tak; Chang, Kai Ping; Guo, Wan Yuo; Chang, Feng Chi; Liang, Muh Lii; Lee, Yi Yen; Chen, Hsin Hung; Yen, Sang Hue; Chen, Yi Wei.

In: Child's Nervous System, Vol. 31, No. 5, 01.05.2015, p. 683-691.

Research output: Contribution to journalArticle

Lai, IC, Wong, T-T, Shiau, CY, Hu, YW, Ho, DMT, Chang, KP, Guo, WY, Chang, FC, Liang, ML, Lee, YY, Chen, HH, Yen, SH & Chen, YW 2015, 'Treatment results and prognostic factors for intracranial nongerminomatous germ cell tumors: single institute experience', Child's Nervous System, vol. 31, no. 5, pp. 683-691. https://doi.org/10.1007/s00381-015-2623-8
Lai, I. Chun ; Wong, Tai-Tong ; Shiau, Cheng Ying ; Hu, Yu Wen ; Ho, Donald Ming Tak ; Chang, Kai Ping ; Guo, Wan Yuo ; Chang, Feng Chi ; Liang, Muh Lii ; Lee, Yi Yen ; Chen, Hsin Hung ; Yen, Sang Hue ; Chen, Yi Wei. / Treatment results and prognostic factors for intracranial nongerminomatous germ cell tumors : single institute experience. In: Child's Nervous System. 2015 ; Vol. 31, No. 5. pp. 683-691.
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AU - Lai, I. Chun

AU - Wong, Tai-Tong

AU - Shiau, Cheng Ying

AU - Hu, Yu Wen

AU - Ho, Donald Ming Tak

AU - Chang, Kai Ping

AU - Guo, Wan Yuo

AU - Chang, Feng Chi

AU - Liang, Muh Lii

AU - Lee, Yi Yen

AU - Chen, Hsin Hung

AU - Yen, Sang Hue

AU - Chen, Yi Wei

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N2 - Purpose: This study aimed to evaluate the treatment of intracranial nongerminomatous germ cell tumors (NGGCT) and to identify the prognostic factors for survival.Methods: Thirty-nine patients with nondisseminated NGGCTs, excluding those with pure mature teratomas, were treated between January 1985 and December 2010. Twenty-four patients received gross total or partial removal, 11 had excision biopsies, and 4 had no surgery. Radiotherapy was given postoperatively or definitively with a median tumor bed dose of 54 Gy (range 30–54) with or without craniospinal irradiation. All patients received ten cycles of adjuvant chemotherapy, vinblastine, bleomycin, etoposide, and cisplatin after radiotherapy, except for one with mixed anaplastic astrocytoma component who received oral temozolomide. Survival and prognostic factors were estimated by the Kaplan–Meier method and log-rank tests, respectively.Results: After a median follow-up of 77.7 months (range 14–336), the 6-year overall survival (OS) and progression-free survival (PFS) were 74.4 and 79.5 %, respectively. Inferior PFS was associated with lesions in the suprasellar region (p = 0.017), poor pathological features (p = 0.048), and with poor image (p < 0.0001) and tumor marker (TM) response (p = 0.003) to irradiation. Decreased OS was associated with lesions in the suprasellar region (p = 0.026) and with poor image (p < 0.0001) and TM response (p = 0.027) to irradiation. Neither the extent of surgery nor the radiation field was found to significantly influence survival.Conclusions: By our multimodality approach, patients achieved comparable outcomes. Other than poor pathological features, patients with poor responses to radiotherapy are prone to early recurrence and inferior survival. These patients should be focused for more intensive adjuvant treatment.

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KW - Surgery

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