Treatment failure in intracranial primary germinomas

Kyu Won Shim, Tae Gon Kim, Chang Ok Suh, Jae Ho Cho, Chul Joo Yoo, Joong Uhn Choi, Jung Hee Kim, Dong Seok Kim

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Object: A radiation dose of 40-50 Gy is able to produce a cure rate of more than 90% in intracranial pure germinoma. However, many attempts have been made to reduce the dose and volume of radiation without compromising the disease control rate because of the toxicity of irradiation. This retrospective study is intended to provide the physician with an appropriate therapeutic strategy. Materials and methods: We reviewed a series of 10 recurrent germinomas among 117 germinomas diagnosed histologically or clinically between 1979 and 2002. These patients involved underwent three different treatment modalities; radiation alone (N = 71), chemotherapy alone (N = 9), and combined therapy (N = 37). The 10-year overall and relapse-free survival rates were 97 and 93% in the radiation alone group, 89 and 67% in the chemotherapy alone group, and 92 and 92% in the combined therapy group, respectively. As expected, both radiation therapy and combined therapy were effective in controlling the disease. Tumor recurrence was closely related to the volume of radiation but not to the dose of radiation. If the tumor bed and craniospinal axis were fully covered, the radiation dose might be reduced. Chemotherapy alone showed earlier recurrence and a higher tumor recurrence rate. In the case of combined therapy, chemotherapy was useful in reducing the radiation dose but revealed some toxicity (death of two patients). Conclusions: The investigation of a possible further dose reduction seems worthwhile. Radiation therapy alone with a dose of less than 40 Gy should be compared with ongoing chemotherapeutic protocols combined with low-dose irradiation.

Original languageEnglish
Pages (from-to)1155-1161
Number of pages7
JournalChild's Nervous System
Volume23
Issue number10
DOIs
Publication statusPublished - 2007 Oct 1

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Germinoma
Treatment Failure
Radiation
Recurrence
Drug Therapy
Radiotherapy
Therapeutics
Neoplasms
Group Psychotherapy
Survival Rate
Retrospective Studies
Physicians

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Shim, K. W., Kim, T. G., Suh, C. O., Cho, J. H., Yoo, C. J., Choi, J. U., ... Kim, D. S. (2007). Treatment failure in intracranial primary germinomas. Child's Nervous System, 23(10), 1155-1161. https://doi.org/10.1007/s00381-007-0394-6
Shim, Kyu Won ; Kim, Tae Gon ; Suh, Chang Ok ; Cho, Jae Ho ; Yoo, Chul Joo ; Choi, Joong Uhn ; Kim, Jung Hee ; Kim, Dong Seok. / Treatment failure in intracranial primary germinomas. In: Child's Nervous System. 2007 ; Vol. 23, No. 10. pp. 1155-1161.
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Shim, KW, Kim, TG, Suh, CO, Cho, JH, Yoo, CJ, Choi, JU, Kim, JH & Kim, DS 2007, 'Treatment failure in intracranial primary germinomas', Child's Nervous System, vol. 23, no. 10, pp. 1155-1161. https://doi.org/10.1007/s00381-007-0394-6

Treatment failure in intracranial primary germinomas. / Shim, Kyu Won; Kim, Tae Gon; Suh, Chang Ok; Cho, Jae Ho; Yoo, Chul Joo; Choi, Joong Uhn; Kim, Jung Hee; Kim, Dong Seok.

In: Child's Nervous System, Vol. 23, No. 10, 01.10.2007, p. 1155-1161.

Research output: Contribution to journalArticle

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T1 - Treatment failure in intracranial primary germinomas

AU - Shim, Kyu Won

AU - Kim, Tae Gon

AU - Suh, Chang Ok

AU - Cho, Jae Ho

AU - Yoo, Chul Joo

AU - Choi, Joong Uhn

AU - Kim, Jung Hee

AU - Kim, Dong Seok

PY - 2007/10/1

Y1 - 2007/10/1

N2 - Object: A radiation dose of 40-50 Gy is able to produce a cure rate of more than 90% in intracranial pure germinoma. However, many attempts have been made to reduce the dose and volume of radiation without compromising the disease control rate because of the toxicity of irradiation. This retrospective study is intended to provide the physician with an appropriate therapeutic strategy. Materials and methods: We reviewed a series of 10 recurrent germinomas among 117 germinomas diagnosed histologically or clinically between 1979 and 2002. These patients involved underwent three different treatment modalities; radiation alone (N = 71), chemotherapy alone (N = 9), and combined therapy (N = 37). The 10-year overall and relapse-free survival rates were 97 and 93% in the radiation alone group, 89 and 67% in the chemotherapy alone group, and 92 and 92% in the combined therapy group, respectively. As expected, both radiation therapy and combined therapy were effective in controlling the disease. Tumor recurrence was closely related to the volume of radiation but not to the dose of radiation. If the tumor bed and craniospinal axis were fully covered, the radiation dose might be reduced. Chemotherapy alone showed earlier recurrence and a higher tumor recurrence rate. In the case of combined therapy, chemotherapy was useful in reducing the radiation dose but revealed some toxicity (death of two patients). Conclusions: The investigation of a possible further dose reduction seems worthwhile. Radiation therapy alone with a dose of less than 40 Gy should be compared with ongoing chemotherapeutic protocols combined with low-dose irradiation.

AB - Object: A radiation dose of 40-50 Gy is able to produce a cure rate of more than 90% in intracranial pure germinoma. However, many attempts have been made to reduce the dose and volume of radiation without compromising the disease control rate because of the toxicity of irradiation. This retrospective study is intended to provide the physician with an appropriate therapeutic strategy. Materials and methods: We reviewed a series of 10 recurrent germinomas among 117 germinomas diagnosed histologically or clinically between 1979 and 2002. These patients involved underwent three different treatment modalities; radiation alone (N = 71), chemotherapy alone (N = 9), and combined therapy (N = 37). The 10-year overall and relapse-free survival rates were 97 and 93% in the radiation alone group, 89 and 67% in the chemotherapy alone group, and 92 and 92% in the combined therapy group, respectively. As expected, both radiation therapy and combined therapy were effective in controlling the disease. Tumor recurrence was closely related to the volume of radiation but not to the dose of radiation. If the tumor bed and craniospinal axis were fully covered, the radiation dose might be reduced. Chemotherapy alone showed earlier recurrence and a higher tumor recurrence rate. In the case of combined therapy, chemotherapy was useful in reducing the radiation dose but revealed some toxicity (death of two patients). Conclusions: The investigation of a possible further dose reduction seems worthwhile. Radiation therapy alone with a dose of less than 40 Gy should be compared with ongoing chemotherapeutic protocols combined with low-dose irradiation.

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