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01-03-2016 | Clinical Study

Outcomes of children with central nervous system germinoma treated with multi-agent chemotherapy followed by reduced radiation

Authors: Sylvia Cheng, John-Paul Kilday, Normand Laperriere, Laura Janzen, James Drake, Eric Bouffet, Ute Bartels

Published in: Journal of Neuro-Oncology | Issue 1/2016

Abstract

CNS germinomas have an excellent prognosis with radiation therapy alone. However, in children, volume and dose of CNS radiation are associated with neurocognitive and neuroendocrine sequelae. Our objective was to determine long-term outcomes of our cohort who received chemotherapy and reduced radiation. This retrospective cohort study analyzed treatment and outcome of intracranial germinoma patients consecutively treated at Sick Kids, Toronto, Canada, from January 2000 to December 2013. 24 children (13 male, 11 female; median age 13.36 years) were identified. Median follow up was 61 months (range 1–144 months). Tumor location was suprasellar (n = 9), bifocal (8), pineal (6), and basal ganglia (1). Three children showed dissemination on imaging. 2/24 had only elevated serum human chorionic gonadotropin, 3/24 only elevated lumbar cerebrospinal fluid (CSF) hCG, and 2/24 had both elevated serum and lumbar CSF hCG. 23/24 children completed treatment and received multi-agent chemotherapy followed by either ventricular radiation (2340–2400 cGy) (n = 9), ventricular radiation + boost (1600 cGy) (n = 8), whole brain (2340 cGy) (n = 3), focal (4000 cGy) (n = 2) or craniospinal radiation (2340 cGy) (n = 1). Five-year progression free and overall survival was 96 and 100 % respectively. 8/24 patients with ventricular radiation ± boost (2340/4000 cGy) displayed stable full scale intelligence quotient over a mean interval of 3 years following radiation, but showed declined processing speed. In this limited experience, excellent 5-year overall survival rates were achieved with chemotherapy followed by reduced whole ventricular radiation even if ventricular radiation was delivered without boost.

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Title: Outcomes of children with central nervous system germinoma treated with multi-agent chemotherapy followed by reduced radiation
Authors: Sylvia Cheng
John-Paul Kilday
Normand Laperriere
Laura Janzen
James Drake
Eric Bouffet
Ute Bartels
Publication date: 01-03-2016
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-015-2029-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcomes of children with central nervous system germinoma treated with multi-agent chemotherapy followed by reduced radiation

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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