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Treatment outcomes and risk factors of patients with intracranial germ cell tumour with choriocarcinoma element or β-HCG level higher than 500 IU/L

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Abstract

Background

In previous studies, patients with intracranial germ cell tumour (iGCT) with pure choriocarcinoma or mixed germ cell tumours with choriocarcinoma element showed similar dismal prognoses, with median overall survival (OS) of 22 months and 1-year survival rate of approximately 60%. However, these conclusions need to be updated because radiotherapy, which is the mainstay for this disease, was not applied in a number of patients. Additionally, prognostic factors need to be explored in this population.

Methods

Clinical data of patients with iGCTs with histologically confirmed choriocarcinoma element or beta-human chorionic gonadotropin (β-HCG) > 500 IU/L were collected from the archives of our institution and retrospectively studied.

Results

A total of 76 patients were eligible for this study. Except for two early deaths, all patients received radiotherapy (craniospinal irradiation [CSI], n = 23; non-CSI, n = 51). The median follow-up duration for the entire series was 63 months (range, 6–188 months). The 5-year event-free survival (EFS) and OS rates were 81.5% and 84.1%, respectively. Among patients who did not have early death or progressive disease after induction chemotherapy, multivariate analysis revealed that chemotherapy cycles (> 4 vs. ≤ 4) (hazard ratio [HR] for EFS 0.144, p = 0.020; HR for OS 0.111, p = 0.028) and β-HCG levels (> 3000 IU/L vs. ≤ 3000 IU/L) (HR for EFS 4.342, p = 0.059; HR for OS 6.614, p = 0.033) were independent factors for survival.

Conclusions

Patients with iGCTs with choriocarcinoma element or β-HCG > 500 IU/L showed improved survival with radiotherapy-based treatments. Additional chemotherapy cycles could result in additional survival benefits. Patients with β-HCG level > 3000 IU/L had poorer prognosis.

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Data availability

All data generated and analyzed during this study are included in this published article (and its supplementary information files).

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Funding

This work was supported by Beijing Municipal Bureau of Health. (Grant number: PXM2019).

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Author notes

  1. Jin Feng and Jing Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4Th Ring West Road, Fengtai District, Beijing, 100070, China

    Jin Feng, Jing Zhang, Li Chen, Xiaoguang Qiu & Bo Li

  2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4Th Ring West Road, Fengtai District, Beijing, 100070, China

    Chunde Li & Wei Liu

  3. Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4Th Ring West Road, Fengtai District, Beijing, 100070, China

    Huiyuan Chen

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Contributions

J. F. and J. Z. conceived the study, designed the study, and drafted the manuscript. L. C., C. L. and W. L. participated in the data collection and analyses. H. C. participated in the histology review. X. Q. and B.L. conceived the study and participated in its design and coordination.

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Correspondence to Xiaoguang Qiu or Bo Li.

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Feng, J., Zhang, J., Chen, L. et al. Treatment outcomes and risk factors of patients with intracranial germ cell tumour with choriocarcinoma element or β-HCG level higher than 500 IU/L. J Neurooncol 166, 331–339 (2024). https://doi.org/10.1007/s11060-024-04565-x

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