Bifocal lesions have a poorer treatment outcome than a single lesion in adult patients with intracranial germinoma

Yu Mei Kang, Yi Yen Lee, Shih Chieh Lin, Feng Chi Chang, Sanford P.C. Hsu, Chun Fu Lin, Muh Lii Liang, Hsin Hung Chen, Tai Tong Wong, Keng Li Lan, Yee Chao, Yi Wei Chen

研究成果: 雜誌貢獻文章同行評審

摘要

Intracranial germinoma (IG) rarely occurs in adults. Its optimal treatment strategy is unclear. We evaluated the outcomes of radiotherapy in adults with intracranial germinoma. Data of 29 adult patients (age, 18-52 years; median age, 24.3 years) with IG treated with radiotherapy at Taipei Veterans General Hospital were retrospectively reviewed. They were followed up for a median time of 5.9 years (range, 1.0-12.8 years). We used the Kaplan-Meier method to estimate the progression-free survival (PFS) and overall survival (OS), and univariate and multivariate Cox proportional hazards regression models to identify the factors affecting PFS. PFS and OS were compared between adult and pediatric patients with IG. The 1-, 3-, and 5-year PFS rates were 96.6%, 85.8%, and 77.8%, respectively, in the adult patients, and the OS rate were all 100%. Seven patients (24.1%) experienced recurrence, and in six of them, salvage therapy successfully controlled the disease. Two patients (6.9%) died after 5 years of follow-up due to disease progression and central pontine myelinolysis. In the univariate and multivariate Cox analysis, bifocal lesions had a significantly lower PFS than those with single lesions (p = 0.008). Kaplan-Meier survival analysis showed that adult patients had a poorer PFS (p = 0.06) and OS (p = 0.025) than pediatric patients. Our study showed bifocal lesions were associated with lower PFS than a single lesion among adult IG patients, and adult IG patients tended to have poorer PFS and OS compared to pediatric IG patients. For adult patients with bifocal IG, we recommend treatment with craniospinal irradiation, whole ventricle irradiation (WVI) with chemotherapy, or frequent spine images followup for patients who received only WVI.

原文英語
文章編號e0264641
期刊PLoS ONE
17
發行號3 March
DOIs
出版狀態已發佈 - 3月 2022
對外發佈

ASJC Scopus subject areas

  • 多學科

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