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Canadian patterns of practice for intracranial germ cell tumors in adolescents and young adults

  • Andrea C. LoEmail author
  • Normand Laperriere
  • David Hodgson
  • Eric Bouffet
  • James Nicholson
  • Michael McKenzie
  • Juliette Hukin
  • Sylvia Cheng
  • Karen J. Goddard
Clinical Study

Abstract

Introduction

The study objectives were to describe patterns of practice for intracranial germ cell tumors (IGCT) in adolescents and young adults (AYA) and to determine factors associated with practice patterns.

Methods

A survey was written containing questions on the management of two 17-year old males, one with localized pineal germinoma and the other with localized pineal non-germinomatous germ cell tumor (NGGCT). An invitation to participate anonymously in the survey was e-mailed to 119 oncologists who treat brain tumors across Canada.

Results

Seventy-two (61%) of the 119 oncologists participated in the study. For the germinoma case, the most common treatment approaches were whole ventricular radiotherapy (WVRT) and chemotherapy (CH) (56%), WVRT alone (15%), and craniospinal radiotherapy (CSRT) alone (10%); for physicians recommending WVRT + CH, most frequently selected whole ventricular doses were 24 Gy (57%) and 18 Gy (20%). Chemotherapy was included in the treatment of germinoma by 96% of pediatric physicians vs. 54% of adult physicians (P = 0.001). The most common treatment approaches for NGGCT were CSRT + CH (44%), WVRT + CH (21%), and pineal gland RT + CH (15%). The selection of craniospinal vs. smaller-volume RT was not associated with the physicians’ specialty, percentage of practice treating brain tumors, number of IGCTs seen, or size of institution.

Conclusions

There is wide variation in the management of IGCT in AYA across Canada. A 17-year old male with a localized pineal germinoma is highly likely to receive chemotherapy if managed by a pediatric oncologist, while the same patient is much less likely to receive chemotherapy if managed by an adult oncologist.

Keywords

Intracranial germ cell tumor CNS Germinoma Non-germinomatous Adolescents and young adults Pediatrics Survey Practice patterns 

Notes

Funding

This study was funded by the Brain Tumour Foundation of Canada.

Compliance with ethical standards

Conflicts of interest

Normand Laperriere has received an honorarium from Abbvie. The other authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11060_2019_3159_MOESM1_ESM.docx (97 kb)
Supplementary material 1 (DOCX 97 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Andrea C. Lo
    • 1
    • 2
    • 6
    • 7
    Email author
  • Normand Laperriere
    • 2
    • 3
    • 7
  • David Hodgson
    • 2
    • 3
    • 7
  • Eric Bouffet
    • 3
    • 7
  • James Nicholson
    • 4
  • Michael McKenzie
    • 1
    • 6
  • Juliette Hukin
    • 5
    • 6
  • Sylvia Cheng
    • 5
    • 6
  • Karen J. Goddard
    • 1
    • 5
    • 6
  1. 1.BC CancerVancouverCanada
  2. 2.Princess Margaret Cancer CentreTorontoCanada
  3. 3.The Hospital of Sick ChildrenTorontoCanada
  4. 4.Addenbrooke’s HospitalCambridgeUK
  5. 5.British Columbia Children’s HospitalVancouverCanada
  6. 6.University of British ColumbiaVancouverCanada
  7. 7.University of TorontoTorontoCanada

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