Abstract | BACKGROUND: We conducted a nonrandomized international study for intracranial germinoma that compared chemotherapy followed by local radiotherapy with reduced-dose craniospinal irradiation (CSI) alone, to determine whether the combined treatment regimen produced equivalent outcome and avoided irradiation beyond the primary tumor site(s). METHODS: RESULTS: Patients with localized germinoma (n = 190) received either CSI alone (n = 125) or combined therapy (n = 65), demonstrating no differences in 5-year event-free or overall survival, but a difference in progression-free survival (0.97 ± 0.02 vs 0.88 ± 0.04; P = .04). Seven of 65 patients receiving combined treatment experienced relapse (6 with ventricular recurrence outside the primary radiotherapy field), and only 4 of 125 patients treated with CSI alone experienced relapse (all at the primary tumor site). Metastatic patients (n = 45) had 0.98 ± 0.023 event-free and overall survival. CONCLUSIONS: Localized germinoma can be treated with reduced dose CSI alone or with chemotherapy and reduced-field radiotherapy. The pattern of relapse suggests inclusion of ventricles in the radiation field. Reduced-dose craniospinal radiation alone is effective in metastatic disease.
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Authors | Gabriele Calaminus, Rolf Kortmann, Jennifer Worch, James C Nicholson, Claire Alapetite, Maria Luisa Garrè, Catherine Patte, Umberto Ricardi, Frank Saran, Didier Frappaz |
Journal | Neuro-oncology
(Neuro Oncol)
Vol. 15
Issue 6
Pg. 788-96
(Jun 2013)
ISSN: 1523-5866 [Electronic] England |
PMID | 23460321
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Etoposide
- Carboplatin
- Ifosfamide
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Topics |
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Brain Neoplasms
(mortality, pathology, therapy)
- Carboplatin
(administration & dosage)
- Chemoradiotherapy
- Child
- Child, Preschool
- Etoposide
(administration & dosage)
- Female
- Follow-Up Studies
- Germinoma
(mortality, pathology, therapy)
- Humans
- Ifosfamide
(administration & dosage)
- International Agencies
- Male
- Neoplasm Grading
- Neoplasm Recurrence, Local
(mortality, pathology, therapy)
- Prognosis
- Prospective Studies
- Survival Rate
- Young Adult
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