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Treatment results and prognostic factors for intracranial nongerminomatous germ cell tumors: single institute experience

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Abstract

Purpose

This study aimed to evaluate the treatment of intracranial nongerminomatous germ cell tumors (NGGCT) and to identify the prognostic factors for survival.

Methods

Thirty-nine patients with nondisseminated NGGCTs, excluding those with pure mature teratomas, were treated between January 1985 and December 2010. Twenty-four patients received gross total or partial removal, 11 had excision biopsies, and 4 had no surgery. Radiotherapy was given postoperatively or definitively with a median tumor bed dose of 54 Gy (range 30–54) with or without craniospinal irradiation. All patients received ten cycles of adjuvant chemotherapy, vinblastine, bleomycin, etoposide, and cisplatin after radiotherapy, except for one with mixed anaplastic astrocytoma component who received oral temozolomide. Survival and prognostic factors were estimated by the Kaplan–Meier method and log-rank tests, respectively.

Results

After a median follow-up of 77.7 months (range 14–336), the 6-year overall survival (OS) and progression-free survival (PFS) were 74.4 and 79.5 %, respectively. Inferior PFS was associated with lesions in the suprasellar region (p = 0.017), poor pathological features (p = 0.048), and with poor image (p < 0.0001) and tumor marker (TM) response (p = 0.003) to irradiation. Decreased OS was associated with lesions in the suprasellar region (p = 0.026) and with poor image (p < 0.0001) and TM response (p = 0.027) to irradiation. Neither the extent of surgery nor the radiation field was found to significantly influence survival.

Conclusions

By our multimodality approach, patients achieved comparable outcomes. Other than poor pathological features, patients with poor responses to radiotherapy are prone to early recurrence and inferior survival. These patients should be focused for more intensive adjuvant treatment.

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Acknowledgments

This work was supported by grants from Taipei Veterans General Hospital (V101B-001, V102B008, and V103C-092); Department of Health, R.O.C. (DOH100-TD-C-111-007), and the Charity Foundation of JUT Land Development Group, Taiwan.

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    Authors and Affiliations

    1. Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, No. 201, Sec.2, Shi-Pai Road, Taipei, 11217, Taiwan

      I-Chun Lai, Cheng-Ying Shiau, Yu-Wen Hu, Sang-Hue Yen & Yi-Wei Chen

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

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

    3. Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan

      Donald Ming-Tak Ho

    4. Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan

      Kai-Ping Chang

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

      Wan-Yuo Guo & Feng-Chi Chang

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

      Tai-Tong Wong, Yu-Wen Hu, Donald Ming-Tak Ho, Wan-Yuo Guo, Feng-Chi Chang, Muh-Lii Liang, Yi-Yen Lee, Hsin-Hung Chen & Yi-Wei Chen

    7. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan

      Yu-Wen Hu

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

      Muh-Lii Liang, Yi-Yen Lee & Yi-Wei Chen

    9. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan

      Sang-Hue Yen

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    1. I-Chun Lai
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    Correspondence to Sang-Hue Yen or Yi-Wei Chen.

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    Sang-Hue Yen and Yi-Wei Chen contributed equally to this work.

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    Lai, IC., Wong, TT., Shiau, CY. et al. Treatment results and prognostic factors for intracranial nongerminomatous germ cell tumors: single institute experience. Childs Nerv Syst 31, 683–691 (2015). https://doi.org/10.1007/s00381-015-2623-8

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    • DOI: https://doi.org/10.1007/s00381-015-2623-8

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