Abstract
Purpose
This study was to clarify the long-term subjective functional state and the therapeutic factors that may influence the outcome and ADL of patients with intracranial germinoma.
Methods and materials
Subjects were 19 patients with an average age of 16.5 years. All patients received radiotherapy with a mean dose of 42.8 Gy, while 14 patients also received chemotherapies. After a median follow-up of 137 months (41–271), a written questionnaire was sent to each patient.
Results
Estimated 5- and 10-year event-free survival rates were 78% and 71%, respectively. Recurrence occurred in 5 patients, and 1 patient died of tumor. The extent of surgery did not affect the incidence of recurrence. Chemotherapy remained adjuvant. Radiotherapy administered to the field encompassing the whole ventricle was essential for long-term tumor control. Only one patient complained of a major treatment-related complication at the time of the questionnaire: radiation-induced cavernomas.
Conclusions
Adverse effects related to treatment are not significant in this study. Radiotherapy of 24 Gy to the field encompassing the whole ventricle is essential, and elective use of chemotherapy and/or additional local boost radiotherapy may prevent recurrence and maintain quality of life (QOL) of the patients for a relatively long period.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Diez B, Balmaceda C, Matsutani M, Weiner HL (1999) Germ cell tumors of the CNS in children: recent advances in therapy. Childs Nerv Syst 15:578–585
Matsutani M. (2004) Clinical management of primary central nervous system germ cell tumors. Semin Oncol 31:676–683
Packer RJ, Cohen BH, Cooney K (2000) Intracranial germ cell tumors. Oncologist 5:312–320
Matsutani M (2001) Japanese pediatric brain tumor study group. Combined chemotherapy and radiation therapy for CNS germ cell tumors—the Japanese experience. J Neurooncol 54:311–316
Saeki N, Murai H, Kubota M, Fujimoto N, Yamaura A (2001) Long-term Karnofsky performance status and neurological outcome in patients with neurohypophyseal germinomas. Br J Neurosurg 15:402–408
Zissiadis Y, Dutton S, Kieran M et al (2001) Stereotactic radiotherapy for pediatric intracranial germ cell tumors. Int J Radiat Oncol Biol Phys 51:108–112
The Ministry of Education, Culture, Sports, Science and Technology, Japan. http://www.mext.go.jp/index.htm
Aoyama H, Shirato H, Ikeda J et al (2002) Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors. J Clin Oncol 20:857–865
Bamberg M, Kortmann RD, Calaminus G et al (1999) Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89. J Clin Oncol 17:2585–2592
Linstadt D, Wara WM, Edwards MS, Hudgins RJ, Sheline GE (1988) Radiotherapy of primary intracranial germinomas: the case against routine craniospinal irradiation. Int J Radiat Oncol Biol Phys 15:291–297
Shibamoto Y, Sasai K, Oya N, Hiraoka M (2001) Intracranial germinoma: radiation therapy with tumor volume-based dose selection. Radiology 218(2):452–456
Wolden SL, Wara WM, Larson DA et al (1995) Radiation therapy for primary intracranial germ-cell tumors. Int J Radiat Oncol Biol Phys 32:943–949
Sawamura Y, de Tribolet N, Ishii N, Abe H (1997) Management of primary intracranial germinomas: diagnostic surgery or radical resection? J Neurosurg 87:262–266
Balmaceda C, Heller G, Rosenblum M et al (1996) Chemotherapy without irradiation—a novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. The First International Central Nervous System Germ Cell Tumor Study. J Clin Oncol 14:2908–2915
Fields JN, Fulling KH, Thomas PR, Marks JE (1987) Suprasellar germinoma: radiation therapy. Radiology 164:247–249
Shirato H, Nishio M, Sawamura Y et al (1997) Analysis of long-term treatment of intracranial germinoma. Int J Radiat Oncol Biol Phys 37:511–515
Sung DI, Harisliadis L, Chang CH (1978) Midline pineal tumors and suprasellar germinomas: highly curable by irradiation. Radiology 128:745–751
Haddock MG, Schild SE, Scheithauer BW, Schomberg PJ (1997) Radiation therapy for histologically confirmed primary central nervous system germinoma. Int J Radiat Oncol Biol Phys 38:915–923
Merchant TE, Sherwood SH, Mulhern RK et al (2000) CNS germinoma: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. Int J Radiat Oncol Biol Phys 46:1171–1176
Oka H, Kawano N, Tanaka T et al (1998) Long-term functional outcome of suprasellar germinomas: usefulness and limitations of radiotherapy. J Neurooncol 40:185–190
Ellenberg L, McComb JG, Siegel SE, Stowe S (1987) Factors affecting intellectual outcome in pediatric brain tumor patients. Neurosurgery 21:638–644
Jannoun L, Bloom HJ (1990) Long-term psychological effects in children treated for intracranial tumors. Int J Radiat Oncol Biol Phys 18:747–753
Rappaport R, Brauner R (1989) Growth and endocrine disorders secondary to cranial irradiation. Pediatr Res 25:561–567
Dattoli MJ, Newall J (1990) Radiation therapy for intracranial germinoma: the case for limited volume treatment. Int J Radiat Oncol Biol Phys 19:429–433
Bhat SR, Goodwin TL, Burwinkle TM et al (2005) Profile of daily life in children with brain tumors: an assessment of health-related quality of life. J Clin Oncol 23:5493–5500
Heckl S, Aschoff A, Kunze S (2002) Radiation-induced cavernous hemangiomas of the brain: a late effect predominantly in children. Cancer 94:3285–3291
Author information
Authors and Affiliations
Corresponding author
Additional information
Satoru Osuka, Koji Tsuboi and Shingo Takano share the first authorship.
Rights and permissions
About this article
Cite this article
Osuka, S., Tsuboi, K., Takano, S. et al. Long-term outcome of patients with intracranial germinoma. J Neurooncol 83, 71–79 (2007). https://doi.org/10.1007/s11060-006-9305-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-006-9305-z