The role of radiotherapy in the treatment of childhood intracranial germinoma: Long-term survival and late effects

• Published in: Pediatric Blood & Cancer Vol. 47; no. 1; pp. 77 - 82
• Main Authors: Strojan, Primož, Zadravec, Lorna Zaletel, Anžič, Jožica, Korenjak, Roman, Jereb, Berta
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.07.2006; Wiley
• Subjects: Adolescent; Biological and medical sciences; Brain Neoplasms - radiotherapy; Central Nervous System Diseases - etiology; chemotherapy; Chemotherapy, Adjuvant - adverse effects; Child; Female; General aspects; Germinoma - radiotherapy; Humans; intracranial germinoma; late effects; Male; Medical sciences; radiotherapy; Radiotherapy - adverse effects; Radiotherapy Dosage; Safety; survival; Survival Analysis; Tumors; Human; Intracranial; Pediatrics; Late; intracranial germinoma; Malignant tumor; Radiotherapy; Long term; Survival; Chemotherapy; Cancerology; Treatment; Germinoma; Child; late effects
• ISSN: 1545-5009; 1545-5017; 1096-911X
• DOI: 10.1002/pbc.20507

Background The aim of the present report was to evaluate the role of radiotherapy in the treatment of childhood intracranial germinoma in view of long‐term survival and functional outcome. Procedure Nine children with histologically verified intracranial germinomas treated in Slovenia between 1983 and 1995 were reviewed. The four boys and five girls were 8.8–16.9 years old (median, 11.3 years). Five tumors were suprasellar, three were in the pineal region, and one patient had bifocal disease. Two patients had disseminated tumor. All patients received radiotherapy: six to the tumor bed, one to the whole brain, and two to the whole central nervous axis (CNA). The doses to the tumor bed ranged from 30 to 46 Gy (median, 44 Gy) and to the CNA were 24 and 34.5 Gy. Five patients received neoadjuvant cyclophosphamide and three patients, all with β‐human chorionic gonadotropin secreting tumors, received neoadjuvant cisplatin‐based chemotherapy. Results Six patients are alive 12.8–21.8 years (median, 19 years) from diagnosis. The causes of death in three patients were disseminated disease, toxicity of salvage chemotherapy, and secondary etoposide‐induced leukemia. All patients with suprasellar tumors presented with overt endocrinopathy. Results of psychological evaluation were subnormal in one out of five patients tested. Estimate of mental deterioration due to therapy ranged from 0% to 30% (median, 15%). Emotional disorder was registered in four patients and psycho‐organic syndrome in three. Conclusions Our results on long‐term survival and functional outcome confirm the efficacy and relative safety of limited‐field and reduced‐dose radiotherapy for childhood intracranial germinoma when supplemented with chemotherapy. © 2005 Wiley‐Liss, Inc.