Abstract | PURPOSE: PATIENTS AND METHODS: Thirty-three patients with GCTs, including 16 pure germinomas, 11 human chorionic gonadotropin-beta ( HCG-beta)-secreting germinomas, three mixed GCTs composed of immature teratomas plus germinomas (IMT/G), and three highly malignant mixed GCTs, were treated. Etoposide and cisplatin (EP) were used for the treatment of solitary pure germinomas, and ifosfamide, cisplatin, and etoposide ( ICE) were used for the treatment of other GCTs. The dose schedule was 24 Gy for germinomas and 40 to 54 Gy for other GCTs. An involved-field set-up was used except for highly malignant GCTs, in which craniospinal irradiation was used. The median follow-up was 58 months (range, 18 to 102 months). RESULTS: Disease-related, overall, and relapse-free survival rates at 5 years were 100%, 93%, and 69% for all patients, 100%, 100%, and 86% for patients with pure germinomas, and 100%, 75%, and 44% for patients with HCG-beta-secreting germinomas, respectively. All six patients with nongerminomatous GCTs were alive at the last follow-up. All eight relapses (one pure germinoma, five HCG-beta-secreting germinomas, and two IMT/G), except one in a course of salvage treatment, were salvaged and free of disease at the last follow-up. No decline was observed in the full-scale, verbal, or performance intelligence quotient at 12 to 51 months after the treatment in 11 patients. CONCLUSION: Our results support an excellent prognosis after EP and ICE regimens followed by radiotherapy. Dose and volume can be reduced to 24 Gy in 12 fractions and involve a field set-up after EP chemotherapy for the treatment of pure germinomas.
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Authors | Hidefumi Aoyama, Hiroki Shirato, Jun Ikeda, Kenji Fujieda, Kazuo Miyasaka, Yutaka Sawamura |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 20
Issue 3
Pg. 857-65
(Feb 01 2002)
ISSN: 0732-183X [Print] United States |
PMID | 11821471
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Chorionic Gonadotropin, beta Subunit, Human
- Etoposide
- Cisplatin
- Ifosfamide
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Topics |
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Brain Neoplasms
(drug therapy, mortality, radiotherapy)
- Child
- Chorionic Gonadotropin, beta Subunit, Human
(metabolism)
- Cisplatin
(therapeutic use)
- Etoposide
(therapeutic use)
- Female
- Germinoma
(drug therapy, mortality, radiotherapy)
- Humans
- Ifosfamide
- Prognosis
- Radiotherapy Dosage
- Survival Rate
- Treatment Outcome
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