Abstract |
The objective of this study was to evaluate retrospectively one institution's experience treating pediatric central nervous system (CNS) pure germinomas with platinum-based chemotherapy followed by focal, reduced-dose irradiation. Eight patients were identified with localized, pure CNS germinomas from 1993 to 2004 at the authors' institution. The median age at diagnosis was 13 years (range 7-19). The median follow-up was 40 months (range 8-141). The tumor location was suprasellar in four, the pineal region in three, and the third ventricle in one. Irradiation was started a median of 20 weeks (range 17-22) from diagnosis and consisted of conformal fields to the primary site as determined by the initial diagnostic MR plus a 1.5- to 2-cm margin. Six of the eight patients received a dose of 3,060 cGy; two patients received 3,600 cGy. The 5-year actuarial event free survival was 71% (56-86%, 95% CI). Two patients suffered marginal (at field edge) failures and both were salvaged using reinduction platinum-based chemotherapy followed by cranial spinal irradiation and a boost to the primary tumor. The 5-year actuarial overall survival was 100%. There were no spinal failures. These data suggest that a reduction in both volume and dose (30.6-36 Gy) retains the excellent survival rates for patients with localized, pure germinomas of the CNS. A higher rate of ventricular relapse rate is observed, although salvage of those patients is feasible.
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Authors | James G Douglas, Jason K Rockhill, James M Olson, Richard G Ellenbogen, J Russell Geyer |
Journal | Journal of pediatric hematology/oncology
(J Pediatr Hematol Oncol)
Vol. 28
Issue 1
Pg. 36-9
(Jan 2006)
ISSN: 1077-4114 [Print] United States |
PMID | 16394891
(Publication Type: Journal Article)
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Chemical References |
- Antineoplastic Agents
- Cisplatin
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Topics |
- Adolescent
- Adult
- Antineoplastic Agents
(administration & dosage)
- Brain Neoplasms
(drug therapy, radiotherapy)
- Child
- Cisplatin
(administration & dosage)
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Germinoma
(drug therapy, radiotherapy)
- Humans
- Male
- Pituitary Gland
(physiology)
- Radiation Dosage
- Retrospective Studies
- Salvage Therapy
- Survival Rate
- Treatment Outcome
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