Abstract
Purpose
The optimal dose and range of radiotherapy for central nervous system (CNS) germinoma have not yet been established. This study aimed to investigate the effects of individualized radiotherapy on the prognosis of patients with germinoma.
Methods
Based on imaging examination, tumor markers, and pathologic results, patients with germinoma received different radiotherapy strategies, including R1 (24 Gy whole ventricular irradiation + tumor-bed boost to 40 Gy), R2 (24–30 Gy craniospinal irradiation + tumor-bed boost to 54 Gy), R3 (24 Gy craniospinal irradiation + tumor-bed boost to 40 Gy), and R4 (30 Gy craniospinal irradiation + tumor-bed boost to 54 Gy with 45 Gy to spinal metastasis).
Results
A total of 77 patients were enrolled in this study between January 2015 and March 2021. The 3-year event-free survival (EFS) and overall survival (OS) of the whole cohort were 94.7% ± 2.6% and 96.0% ± 2.3%, respectively. The 3-year EFS for patients with localized and metastatic disease were 96.6% ± 2.4% and 89.2% ± 7.2%, respectively. The 3-year EFS of patients receiving R1, R2, R3, and R4 radiotherapy were 100%, 94.1% ± 5.7%, 100%, and 86.2% ± 9.1%, respectively.
Conclusion
Good prognosis was still achieved after reducing dose and extent of radiation for the patients who achieved complete response (CR) after induction chemotherapy or pathological CR after second-look surgery.
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Data availability
Research data were uploaded onto the Research Data Deposit public platform (www.researchdata.org.cn), with the approval RDD number as RDDA2023424335. Research data will be shared upon request to the corresponding author.
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Conceptualization, supervision, and project administration were performed by Xiaofei Sun and Zijun Zhen. Original Draft was written by Chenggong Zeng and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Data curation, formal analysis, software and methodology were performed by Chenggong Zeng, Qunying Yang, Zhuoran Li, Zhiqing Wei, and Tingting Chen. Investigation, sources and visualization were performed by Qunying Yang, Meiling Deng, Jian Wang, Juan Wang, Feifei Sun, Junting Huang, Suying Lu, Jia Zhu, Xiaofei Sun, and Zijun Zhen. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Review Committee of Sun Yat-sen University Cancer Center (ethical consent number: B2022-600-01).
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Chenggong Zeng, Qunying Yang and Zhuoran Li contributed equally to the project and are co-first authors.
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Zeng, C., Yang, Q., Li, Z. et al. Treatment outcomes for response-based radiotherapy in children and adolescents with central nervous system germinoma: a prospective study. J Neurooncol 164, 643–653 (2023). https://doi.org/10.1007/s11060-023-04453-w
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DOI: https://doi.org/10.1007/s11060-023-04453-w