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Journal of Neuro-Oncology

, Volume 121, Issue 3, pp 541–548 | Cite as

Treatment strategies and long-term outcomes for primary intramedullary spinal germinomas: an institutional experience

  • Liang Wu
  • Tao Yang
  • Xiaofeng Deng
  • Chenlong Yang
  • Jingyi Fang
  • Yulun Xu
Clinical Study

Abstract

Primary intramedullary germinomas are very rare tumors in the spinal cord. This study presented a series of 11 patients with histologically proven primary intramedullary spinal germinomas. Their clinical and radiological findings, treatment records and long-term outcomes were reviewed. There were four male and seven female patients with a mean age of 27.1 years. Because germ cell tumors were suspected by frozen-section biopsy, gross total resection was unattempted. Partial resection was performed in four cases, while biopsy was performed in seven cases. Postoperatively, carboplatin and etoposide chemotherapy combined with low dose radiotherapy (30.6 Gy) to local spine was performed in seven cases, followed by radiotherapy alone (40 Gy) in four cases. All 11 patients had a complete response to either combination treatment or single radiotherapy, and the mass effect on the spinal cord vanished. The mean follow-up period was 75.4 months. At the last follow-up, the symptoms were improved in 10 cases and the current status of one patient was unchanged. The postoperative follow-up magnetic resonance imaging showed no recurrence or dissemination in any of the patients. Primary intramedullary germinomas are amenable to adjuvant radiochemotherapy and low dose radiation with etoposide and carboplatin chemotherapy is recommended. When combination therapy cannot be performed, relatively high doses of radiotherapy are advised, and radiation to the craniospinal axis may be unnecessary. A good clinical outcome after combination therapy or radiotherapy alone can be expected, and the risk of long-term recurrence and dissemination is low.

Keywords

Germinoma Radiochemotherapy Intramedullary Spinal cord Germ cell tumor 

Notes

Acknowledgments

We would like to thank all the patients who trusted us and all the physicians and staff who helped this study.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings described in this paper. No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this manuscript.

Ethical standards

This retrospective study was approved by Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Liang Wu
    • 1
  • Tao Yang
    • 1
  • Xiaofeng Deng
    • 1
  • Chenlong Yang
    • 1
  • Jingyi Fang
    • 2
  • Yulun Xu
    • 1
  1. 1.Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of Neuropathology, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina

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