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A single-center study of treatment outcomes of pediatric basal ganglia germinoma in Taiwan

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Abstract

Purpose

A basal ganglia (BG) germinoma is a rare tumor, and the optimal treatment remains unknown. We evaluated the clinical outcomes of treatment of BG germinoma in pediatric patients in Taiwan.

Methods

We retrospectively reviewed the medical records of 34 children with BG germinoma who were treated with radiotherapy (RT) at Taipei Veterans General Hospital between 1989 and 2016. The median follow-up time is 8.3 years (1.8–25.2 years). Survival was analyzed using the Kaplan–Meier estimate. Univariate Cox proportional-hazards models were used to identify the potential risk factors.

Results

Only four patients (11.8%) experienced recurrence and all successfully underwent salvage therapy. One patient (2.97%) died due to suspected radiotherapy (RT)-related sarcoma in the scalp. The 2-, 3-, and 5-year DFS rates were 91.2%, 88.2%, and 79.4%, respectively; the 2-, 3-, and 5-year OS rates were 97.1%, 94.1%, and 82.4%, respectively. Focal RT showed low DFS in the Kaplan–Meier survival curves (P = .028) compared with non-focal RT (whole ventricle, whole brain, or cranial spinal area). In the univariate Cox proportional-hazards model, there was a significant difference in DFS between focal and non-focal RT (P = .03). There is no difference in DFS and OS between BG germinoma patients and non-BG germinoma patients.

Conclusions

We found an excellent DFS and OS in pediatric patients with BG germinoma treated with RT. Whole ventricle irradiation is recommended for good tumor control and low treatment-related toxicity. BG germinoma patients showed similar treatment results as germinoma patients in other common sites.

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Acknowledgments

We would like to express our gratitude to all the members in Pediatric Neuro-Oncology Team and Department of Oncology. Special thanks to psychologist Shih-Yuan Liang for providing neurocognitive information to us.

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Authors and Affiliations

  1. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Yu-Mei Kang, Shih-Chieh Lin, Yi-Yen Lee, Feng-Chi Chang, Muh-Lii Liang, Hsin-Hung Chen, Tai-Tong Wong & Yi-Wei Chen

  2. Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan

    Yu-Mei Kang & Yi-Wei Chen

  3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

    Yu-Mei Kang

  4. Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Shih-Chieh Lin

  5. Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Yi-Yen Lee, Muh-Lii Liang, Hsin-Hung Chen & Tai-Tong Wong

  6. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Feng-Chi Chang

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Correspondence to Yi-Wei Chen.

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Kang, YM., Lin, SC., Lee, YY. et al. A single-center study of treatment outcomes of pediatric basal ganglia germinoma in Taiwan. Childs Nerv Syst 36, 1745–1753 (2020). https://doi.org/10.1007/s00381-020-04543-4

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