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Central Nervous System Germ Cell Tumors

The Impact of Treatment on Patient Outcome

  • Review Article
  • Published:
American Journal of Cancer

Abstract

Primary central nervous system (CNS) germinoma is readily curable with relatively large volume/high dose radiotherapy but the late effects of treatment may alter neurocognitive functioning and quality of life. Prior studies have associated radiation therapy with deficits in the domains of intelligence, attention, memory, and psychomotor processing speed, with risk factors including young age at irradiation and increased irradiation volume and dosage level. Furthermore, cranial irradiation may also lead to diminished height, neuroendocrine dysfunction, and hearing loss.

Few germ cell tumor follow-up studies have adequately examined the late effects of therapy, with results varying between lowered physical quality of life without significant cognitive sequelae to significant correlations between young age at treatment and lowered levels of intellectual functioning and quality of life. Consequently, further investigation is warranted that includes baseline and biannual psychological assessments that focus beyond a singular measure of intelligence and provide data on a range of domains such as attention-concentration, memory and executive functioning, as well as quality of life, social-emotional and behavioral functioning.

Since systemic and CNS germ cell tumors are highly sensitive to chemotherapy as well as to radiotherapy, future studies should examine whether the addition of chemotherapy prior to radiotherapy will permit response-based reductions in radiotherapy fields and allow the administration of doses that will translate into meaningful improvements in functional outcome with preservation of excellent long-term disease control.

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Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The author has no conflicts of interest that are directly relevant to the content of this review.

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  1. Herbert Irving Division of Child and Adolescent Oncology, Columbia University College of Physichemotherapy cians and Surgeons, Irving Pavilion, 7th Floor, 161 Fort Washington Avenue, New York, NY, 10032-3784, USA

    Stephen A. Sands

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Sands, S.A. Central Nervous System Germ Cell Tumors. Am J Cancer 3, 41–46 (2004). https://doi.org/10.2165/00024669-200403010-00004

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