Skip to main content
SpringerLink
Log in

Combined chemotherapy and radiotherapy for intracranial germinomas in adultpatients: a single-institution study

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

We report on our experience in the treatment of intracranial germinomas (18 pure germinomas and two germinomas with syncytiotrophoblastic giant cells) according to a strategy of radiotherapy doses and fields reduction after a neoadjuvant chemotherapy (Cisplatin-vinblastine and bleomycin combination). Radiation therapy was delivered after the completion of the third and last course of chemotherapy. For the solitary germinoma the target volume was the gross tumour volume. In the five multifocal germinoma patients the whole ventricle volume was irradiated. For the single disseminated germinoma patient we treated the whole central nervous system. The cumulative doses were 30 Gy for the pure germinomas. For the STGCs, a cumulative dose of 35 Gy was used. The median follow-up was 55 months (range 12–120). 18 patients were alive without recurrence of disease. In the two patients with STGCs the death took place 16 and 35 months after diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Rosemblum MK, Matsutami M, Van Meir EG: CNS germ cell tumors. In: Kleiheues P, Cavanee WK (eds) Pathology and Genetic of Tumor of the Nervous system. IARC Press Lyon, 2000, pp 208–214.

  • Y Shibamoto K Sasai N Oya M Hiraoka (2001) ArticleTitleIntracranial germinoma: radiation therapy with tumor volume-based dose selection Radiology 218 452–456

    Google Scholar 

  • JC Allen RC DaRosso B Donahue A Nirenberg (1994) ArticleTitleA phase II trial of preirradiation carboplatin in newly diagnosed germinoma of the central nervous system Cancer 74 940–944

    Google Scholar 

  • LC Wong TL Yang F Gao AM Tan VK Sethi EJ Chua (2002) ArticleTitleIntracranial germ cell tumour: experience of a Singaporean institution over 11-year period Singapore Med J 43 182–188

    Google Scholar 

  • RJ Packer LN Sutton TE Atkins J Radcliffe GR Bunin G D’Angio KR Siegel L Schut (1989) ArticleTitleA prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results J Neurosurg 70 707–713

    Google Scholar 

  • EA Schriock MJ Schell M Carter O Hustu JJ Ochs (1991) ArticleTitleAbnormal growth patterns and adult short stature in 115 long-term survivors of childhood leukemia J Clin Oncol 9 400–405

    Google Scholar 

  • R Jakacki (2002) ArticleTitleCentral nervous system germ cell tumors Curr Treat Options Neurol 4 139–145

    Google Scholar 

  • C Balmaceda G Heller M Rosenblum B Diez JG Villablanca S Kellie P Maher V Vlamis RW Walker S Liebel JL Finay (1996) ArticleTitleChemotherapy 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

    Google Scholar 

  • H Aoyama H Shirato J Ikeda K Fujieda K Miyasaka Y Sawamura (2002) ArticleTitleInduction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors J Clin Oncol 20 857–865

    Google Scholar 

  • DR Macdonald TL Cascino SC Schold SuffixJr JG Cairncross (1990) ArticleTitleResponse criteria for phase II studies of supratentorial malignant glioma J Clin Oncol 8 1277–1280

    Google Scholar 

  • A Basso E Capitani M Laiacona (1987) ArticleTitleRaven’s coloured progressive matrices: normative values on 305 adult normal controls Funct Neurol 2 189–194

    Google Scholar 

  • H Spinnler G Tognoni (1987) ArticleTitleStandardizzazione e taratura italiana di test neuropsicologici Ital J Neurol Sci 8 47–50

    Google Scholar 

  • Lezak M: Neuropsychological Assessment. Oxford University Press, New York, 1995, pp 170–193.

  • EL Kaplan P Meier (1958) ArticleTitleNon parametric estimation from incomplete observations J Am Stat Assoc 53 457–481

    Google Scholar 

  • Y Sawamura N Tribolet Particlede N Ishii H Abe (1997) ArticleTitleManagement of primary intracranial germinomas: diagnostic surgery or radical resection J Neurosurg 87 262–266

    Google Scholar 

  • S Oi M Shibata J Tominaga Y Honda M Shinoda F Takei R Tsugane K Matsuzawa O Sato (2000) ArticleTitleEfficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumours J Neurosurg 93 245–253 Occurrence Handle1:STN:280:DC%2BD3cvhtl2qtg%3D%3D Occurrence Handle10930010

    CAS  PubMed  Google Scholar 

  • R Pallini V Bozzini M Scerrati C Zuppi B Zappacosta GF Rossi (1991) ArticleTitleBone metastasis associated with shunt-related peritoneal deposits from a pineal germinoma Case report and review of the literature. Acta Neurochir 109 78–83

    Google Scholar 

  • JM Buatti WA Friedman (2002) ArticleTitleTemporary ventricular drainage and emergency radiotherapy in the management of hydrocephalus associated with germinoma J Neurosurg 96 1020–1022

    Google Scholar 

  • M Matsutani K Sano K Takakura T Fujimaki O Nakamura N Funata T Seto (1997) ArticleTitlePrimary intracranial germ cell tumors: A clinical analysis of 153 histologically verified cases J Neurosurg 86 446–455

    Google Scholar 

  • Y Shibamoto M Takahashi K Sasai (1997) ArticleTitlePrognosis of intracranial germinoma with syncytiotrophoblastic giant cells treated by radiation therapy Int J Radiat Oncol Biol Phys 37 505–510

    Google Scholar 

  • G Calaminus L Andreussi ML Garre RD Kortmann R Schober U Gobel (1997) ArticleTitleSecreting germ cell tumors of the CNS: first results of the cooperative German/Italian Pilot Study Klin Pediatr 209 222–227

    Google Scholar 

  • T Kumabe Y Kusaka H Jokura H Ikeda R Shirane T Yoshimoto (2002) ArticleTitleRecurrence of intracranial germinoma initially treated with chemotherapy only No Shinkei Geka 30 935–942

    Google Scholar 

  • MG Haddock SE Schild BW Scheithauer PJ Schomberg (1997) ArticleTitleRadiation therapy for histologically confirmed primary central nervous system germinoma Int J Radiat Oncol Biol Phys 38 915–923

    Google Scholar 

  • TE Merchant SH Sherwood RK Mulhern SR Rose SJ Thompson RA Sanford LE Kun (2000) ArticleTitleCNS germinoma: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation Int J Radiat Oncol Biol Phys 15 1171–1176

    Google Scholar 

  • H Shirato M Nishio Y Sawamura M Myohjin T Kitahara M Nishioka Y Mizutani H Abe K Miyasaka (1997) ArticleTitleAnalysis of long-term treatment of intracranial germinoma T Int J Radiat Oncol Biol Phys 37 511–515

    Google Scholar 

  • RJ Packer BH Cohen K Coney (2000) ArticleTitleIntracranial germ cell tumors The Oncologist 5 312–320

    Google Scholar 

  • MJ Dattoli J Newall (1990) ArticleTitleRadiation therapy for intracranial germinoma: the case for limited volume treatment Int J Radiat Oncol Biol Phys 19 429–433

    Google Scholar 

  • Y Shibamoto M Takahashi M Abe (1994) ArticleTitleReduction of the radiation dose for intracranial germinoma: a prospective study Br J Cancer 70 984–989

    Google Scholar 

  • K Kitamura H Shirato Y Sawamura K Suzuki J Ikeda K Miyasaka (1999) ArticleTitlePreirradiation evaluation and technical assessment of involved-field radiotherapy using computed tomographic (CT) simulation and neoadjuvant chemotherapy for intracranial germinoma Int J Radiat Oncol Biol Phys 43 783–788

    Google Scholar 

  • Y Sawamura H Shirato J Ikeda M Tada N Ishii T Kato H Abe K Fujieda (1998) ArticleTitleInduction chemotherapy followed by reduced-volume radiation therapy for newly diagnosed central nervous system germinoma J Neurosurg 88 66–72

    Google Scholar 

  • Y Matsukado H Abe R Tanaka T Kobayashi J Yamashita A Nishimoto Y Ushio K Sato M Matsutani K Takakura (1986) ArticleTitleCisplatin, vinblastine and bleomycin (PVB) combination chemotherapy in the treatment of intracranial malignant germ cell tumors–a preliminary report of a phase II study–The Japanese Intracranial Germ Cell Tumor Study Group Gan No Rinsho 32 1387–1393

    Google Scholar 

  • H Shirato M Nishio Y Sawamura M Myohjin T Kitahara T Nishioka Y Mizutani H Abe K Miyasaka (1997) ArticleTitleAnalysis of long-term treatment of intracranial germinoma Int J Radiat Oncol Biol Phys 37 511–515

    Google Scholar 

  • A Behin JY Delattre (2003) Neurological sequelae of radiotherapy of the nervous system D Shiff PY Wen (Eds) Cancer Neurology in Clinical Practice Humana Press Totowa, New Jersey 173–191

    Google Scholar 

  • AR Giovagnoli (1999) ArticleTitleQuality of life in patients with stable disease after surgery, radiotherapy, and chemotherapy for malignant brain tumour J Neurol Neurosurg Psychiatry 67 358–363

    Google Scholar 

  • DA Haas-Kogan BT Missett WM Wara SS Donaldson KR Lamborn MD Prados PG Fisher SL Huhn BM Fisch MS Berger QT Le (2003) ArticleTitleRadiation therapy for intracranial germ cell tumors Int J Radiat Oncol Biol Phys 56 511–518

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuro-Oncology, Istituto Nazionale Neurologico, “Carlo Besta”, Milan, Italy

    Antonio Silvani, Marica Eoli, Andrea Salmaggi, Elena Lamperti & Amerigo Boiardi

  2. Radiotherapy Unit, Istituto Nazionale Neurologico, “Carlo Besta”, Milan, Italy

    Laura Fariselli & Ida Milanesi

  3. Department of Neurosurgery, Istituto Nazionale Neurologico, “Carlo Besta”, Milan, Italy

    Giovanni Broggi, Carlo Lazzaro Solero & Sergio Giombini

Authors
  1. Antonio Silvani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marica Eoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Salmaggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elena Lamperti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laura Fariselli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ida Milanesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giovanni Broggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Carlo Lazzaro Solero
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sergio Giombini
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Amerigo Boiardi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonio Silvani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Silvani, A., Eoli, M., Salmaggi, A. et al. Combined chemotherapy and radiotherapy for intracranial germinomas in adultpatients: a single-institution study. J Neurooncol 71, 271–276 (2005). https://doi.org/10.1007/s11060-004-1496-6

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-004-1496-6

Keywords

Search

Navigation