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Current advances in the diagnosis and management of intracranial germ cell tumors

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Abstract

Central nervous system (CNS) germ cell tumors (GCT) account for less than 5% of primary brain tumors in children and young adults, but they continue to attract much attention. Over the past decade, two advances have led to re-evaluation of what constitutes conventional therapy for CNS GCT. For pure germinomas, the challenge remains the determination of the optimal field and dose of irradiation and whether or not the use of chemotherapy can lead to a reduced dose or elimination of irradiation altogether without compromising disease control or survival. For non-germinomatous germ cell tumors, an improvement in the current dismal prognosis is imperative.

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References and Recommended Reading

  1. Matsutani M, Sano K, Takjakura K, et al.: Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 1997, 86:446–455.

    PubMed  CAS  Google Scholar 

  2. Bamberg M, Kortmann RD, Calaminus G, et al.: Radiaiton therapy for intracranial germinoma: results of the German cooperative prospective trial MAKEI 83/86/89. J Clin Oncol 1999, 17:2585–2592.

    PubMed  CAS  Google Scholar 

  3. Einhorn LH, Donohue JP: Chemotherapy for disseminated testicular cancer. Urol Clin North Am 1977, 4:407–426.

    PubMed  CAS  Google Scholar 

  4. Matsutani M, Sano K, Takakura K, et al.: Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 1997, 86:446–455.

    PubMed  CAS  Google Scholar 

  5. Balmaceda C, Heller G, Rosenblum R, et al.: Chemotherapy without irradiation—a novel approach for newly diagnosed central nervous system germ cell tumors: results of an international cooperative trial. J Clin Oncol 1996, 14:2908–2915.

    PubMed  CAS  Google Scholar 

  6. Calaminus G, Bamberg M, Baranzelli MC, et al.: Intracranial germ cell tumors: a comprehensive update of the European data. Neuropediatrics 1994, 25:26–32.

    PubMed  CAS  Google Scholar 

  7. Sawamura Y, Ikeda J, Shirato H, et al.: germ cell tumors of the central nervous system: treatment considerations bases on 111 cases and their long-term clinical outcome. Eur J Cancer 1998, 34:104–110.

    Article  PubMed  CAS  Google Scholar 

  8. Hooda BS, Finlay JL: Recent advances in the diagnosis and treatment of central nervous system germ-cell tumors. Curr Opin Neurol 1999, 12:693–696.

    Article  PubMed  CAS  Google Scholar 

  9. Bruce JN, Stein BM: Surgical management of pineal region tumors. Acta Neurochir (Wien) 1995, 134:130–135.

    Article  CAS  Google Scholar 

  10. Weiner HL, Finlay JL: Surgery in the management of primary intracranial germ cell tumors. Child Nerv Syst 1999, 15:770–773.

    Article  CAS  Google Scholar 

  11. Schild SE, Haddock MG, Scheithauer BW, et al.: Non germinomatous germ cell tumors of the brain. Int J Radiat Oncol Biol Phys 1996, 36:557–563.

    Article  PubMed  CAS  Google Scholar 

  12. Sawamura Y, Tribolet N, Ishii N, et al.: Management of primary intracranial germinomas: diagnostic surgery or radical resection. J Neurosurg 1997, 87:262–266.

    PubMed  CAS  Google Scholar 

  13. Nam DH, Cho BK, Shin HJ, et al.: Treatment of intracranial non germinomatous malignant germ cell tumor in children: the role of each treatment modality. Child Nerv Syst 1999, 15:185–191.

    Article  CAS  Google Scholar 

  14. Baranzelli MC, Patte C, Bouffet E, et al.: Nonmetastatic intracranial germinoma: the experience of the French Society of Pediatric Oncology. Cancer 1997, 80:1792–1797.

    Article  PubMed  CAS  Google Scholar 

  15. Buckner JC, Peethambaram PP, Smithson WE, et al.: Phase II trial of primary chemotherapy followed by reduced-dose radiaiton for CNS germ cell tumors. J Clin Oncol 1999, 933–940.

  16. Dearnaley DP, Ahern RP, Whittaker S, Bloom HJ: Pineal and CNS germ cell tumors: Royal Mardsden Hospital experience 1962–1987. Int J Radiat Oncol Biol Phys 1990, 18:773–781.

    PubMed  CAS  Google Scholar 

  17. Haddock MG, Schild SE, Scheithauer BW, et al.: Radiation therapy for histologically confirmed primary central nervous system germinoma. Int J Radiation Oncol Biol Phys 1997, 38:915–923.

    Article  CAS  Google Scholar 

  18. Shirato H, Nishio K, Sawamura Y, et al.: Analysis of long-term treatment of intracranial germinoma. Int J Rad Oncol Biol Phys 1997, 37:511–515.

    Article  CAS  Google Scholar 

  19. Dattoli MJ, Newall J: Radiation therapy for intracranial germinoma: the case for limited volume treatment. Int J Radiat Oncol Biol Phys 1990, 19:429–433.

    PubMed  CAS  Google Scholar 

  20. Kersh R, Constable W, Dmrt C, et al.: Primary central nervous system germ cell tumors. Cancer 1988, 61:2148–2152.

    Article  PubMed  CAS  Google Scholar 

  21. Aoyama H, Shirato H, Kakutou Y, et al.: Pathologically proven intracranial germinoma treated with radiation therapy. Radiat Oncol 1998, 1998, 47:201–205.

    Article  CAS  Google Scholar 

  22. Shibamoto Y, Takahashi M, Abe M: Reduction of the radiation dose for intracranial germinoma: a prospective study. Br J Cancer 1994, 70:984–989.

    PubMed  CAS  Google Scholar 

  23. Aydin F, Ghatak N, Radie-Keane K, et al.: The short-term effect of low-dose irradiation on intracranial germinoma. Cancer 1992, 69:2322–2326.

    Article  PubMed  CAS  Google Scholar 

  24. Wolden SL, Wara WM, Larson DA, et al.: Radiation therapy for intracranial germ-cell tumors. Int J Rad Oncol Biol Phys 1995, 32:943–949.

    Article  CAS  Google Scholar 

  25. Manera L, Regis J, Chinot O, et al.: Pineal region tumors: the role of stereotactic radiosurgery. Stereotact Funct Neurosurg 1996, 66(suppl 1):164–173.

    Article  PubMed  Google Scholar 

  26. Allen JC, Kim JH, Packer JR: Neoadjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system. Neurosurgery 1987, 67:65–70.

    CAS  Google Scholar 

  27. Allen JC, DaRosa RC, Donahue B, et al.: A phase II trial of pre-irradiation carboplatin in newly diagnosed germinoma of the central nervous system. Cancer 1994, 74:940–944.

    Article  PubMed  CAS  Google Scholar 

  28. Bouffet E, Baranzelli MC, Patte C, et al.: Combined treatment modality for intracranial germinomas: results of a multicenter SFOP experience. Br J Cancer 1999, 79:1199–1204.

    Article  PubMed  CAS  Google Scholar 

  29. Sawamura Y, Shirato H, Ikeda J, et al.: Induction chemotherapy followed by reduced-volume radiaiton therapy for newlydiagnosed central nervous system germinoma. J Neurosurg 1998, 88:66–72.

    PubMed  CAS  Google Scholar 

  30. Matsutani M, Ushio Y, Abe H, et al.: Combined chemotherapy and radiaiton therapy for central nervous system germ cell tumors: preliminary results of a Phase II study of the Japanese Pediatric Brain Tumor study Group. Neurosurgery Focus 1996, 5:Article 7.

  31. Fouladi M, Grant R, Baruchel S, et al.: Comparison of survival outcome in patients with intracranial germinoma treated with radiation alone versus reduced dose radiation and chemotherapy. Child Nervous Syst 1998, 14:596–601.

    Article  CAS  Google Scholar 

  32. Sawamura Y, Shirato H, De Tribolet N: Recent advances in the treatment of central nervous system germ cell tumors. Adv Tech Stand Neurosurg 1999, 25:141–159.

    PubMed  CAS  Google Scholar 

  33. Matsutani M, Sano K, Takakura K, et al.: Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 1997, 86:446–455.

    Article  PubMed  CAS  Google Scholar 

  34. Ushio Y, Kochi M, Kuratsu J, et al.: preliminary observations for a new treatment in children with primary intracranial yolk sac tumor or embryonal carcinoma. report of 5 cases. J Neurosurg 1999, 90:133–137.

    Article  PubMed  CAS  Google Scholar 

  35. Knapp UJ, Bentele K, Horstmann HD: Treatment and long term outcome of pineal non germinomatous germ cell tumors. Pediatr Neurosurg 1999, 28:241–245.

    Article  Google Scholar 

  36. Calaminus G, Andreussi L, Garre ML, et al.: Secreting germ cell tumors of the central nervous system (CNS). First results of the cooperative German/Italian Pilot Study (central nervous system germ cell tumors). Klin Pediatr 1997, 209:222–227.

    CAS  Google Scholar 

  37. Matsutani M: Combined chemotherapy and radiation therapy for CNS germ cell tumors-the Japanese experience. J Neuro-oncol 2001, 54:311–316. Important study.

    Article  CAS  Google Scholar 

  38. Finlay JL: The role of high dose chemotherapy and stem cell rescue in the treatment of malignant brain tumors: a reappraisal. Pediatr Transplant 1999, 3(suppl 1):87–95.

    Article  PubMed  Google Scholar 

  39. Baranzelli MC, Patte C, Bouffet E, et al.: An attempt to treat pediatric intracranial AFP and BHCG secreting GCT with chemotherapy alone. SFOP experience with 18 cases. J Neuro-oncol 1998, 37:229–239.

    Article  CAS  Google Scholar 

  40. Matsukado Y: The Japanese intracranial germ cell tumor study group: cisplatin, vinblastine, and bleomycin (PVB) combination chemotherapy in the treatment of intracranial malignant germ cell tumors-a preliminary report of a phase Ii study. Gan No Rinsho 1986, 32:1387–1393.

    PubMed  CAS  Google Scholar 

  41. Kellie S, Boyce H, Lichtenbaum R, et al, for the Second International CNS Germ Cell Tumor Study Group: Results of the Second International CNS Germ Cell Tumor (GCT) Study Group Protocol. Results of the Second International CNS GCT Study Group. Neuro-Oncology 2003, 5:47.

    Google Scholar 

  42. Gobel U, Calaminus G, Schneider DT, et al.: Management of germ cell tumors in children: approaches to cure. Onkologie 2002, 25:14–22. Important study.

    Article  PubMed  CAS  Google Scholar 

  43. Wessalowski R, Kruck H, Pape H, et al.: Hyperthermia for the treatment of patients with malignant germ cell tumors: a phase I/II study in ten children and adolescents with recurrent or refractory tumors. Cancer 1998, 82:793–800.

    Article  PubMed  CAS  Google Scholar 

  44. Doolittle ND, Miner ME, Hall WA, et al.: Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjunction with osmotic opening of the blood brain barrier for the treatment of patients with malignant brain tumors. Cancer 2000, 88:637–647.

    Article  PubMed  CAS  Google Scholar 

  45. Merchant TE, Sherwood SH, Mulhem RK, et al.: CNS germinoma: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. Int Radiat Oncol Biol Phys 2000, 46:1171–1176.

    Article  CAS  Google Scholar 

  46. Sawamura Y, Ikeda JL, Tada M, Shirato H: Salvage therapy for recurrent germinomas in the central nervous system. Br J Neurosurg 1999, 13:376–381.

    Article  PubMed  CAS  Google Scholar 

  47. Nishizaki T, Kajiwara K, Adachi N, et al.: Detection of craniospinal dissemination of intracranial germ cell tumors based on serum and cerebrospinal fluid levels of tumor markers. J Clin Neurosci 2001, 8:27–30.

    Article  PubMed  CAS  Google Scholar 

  48. Fujimaki T, Mishima K, Asai A, et al.: Levels of B-human chorionic gonadotropin in cerebrospinal fluid of patients with malignant germ cell tumor can be used to detect early recurrence and monitor the response to treatment. Jpn J Clin Oncol 2000, 30:291–294.

    Article  PubMed  CAS  Google Scholar 

  49. Sutton LN, Radcliffe J, Goldwein JW, et al.: Quality of life of adult survivors of germinomas treated with craniospinal irradiation. Neurosurgery 1999, 45:1292–1297.

    Article  PubMed  CAS  Google Scholar 

  50. Weiner HL, Pietanza MC, Sands S, et al.: Chemotherapy without irradiation for newly diagnosed CNS germ cell tumors, long term follow-up and quality of life on an international cooperative trial. J Neurosurg 1999, 90:421A.

    Google Scholar 

  51. Schmugge M, Boltshauser E, Pluss HJ, Niggli FK: Longterm follow-up and residual sequelae after treatment for intracerebral germ-cell tumor in children an adolescents. Ann Oncol 2000, 11:527–533.

    Article  PubMed  CAS  Google Scholar 

  52. Saeki N, Murai H, Kubota M, et al.: Long-term Karnofsky performance status and neurological outcome in patients with neurohypophyseal germinomas. Br J Neurosurg 2001, 15:402–408.

    Article  PubMed  CAS  Google Scholar 

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  1. Neurological Institute, Columbia University College of Physicians & Surgeons, 710 W. 168th Street, 10032, New York, NY, USA

    Casilda Balmaceda MD & Jonathan Finlay MB, ChB

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  1. Casilda Balmaceda MD
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  2. Jonathan Finlay MB, ChB
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Balmaceda, C., Finlay, J. Current advances in the diagnosis and management of intracranial germ cell tumors. Curr Neurol Neurosci Rep 4, 253–262 (2004). https://doi.org/10.1007/s11910-004-0046-0

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  • DOI: https://doi.org/10.1007/s11910-004-0046-0

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