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01-05-2022 | Thrombocytopenia | Original Article

Survival outcomes, hematologic complications and growth impairment after sequential chemoradiotherapy in intracranial NGGCTs: a retrospective study

Authors: Lei Wen, Juan Li, Mingyao Lai, Zhaoming Zhou, Qingjun Hu, Guanhua Deng, Changguo Shan, Ruyu Ai, Hainan Li, Ming Lu, Liang Zhang, Taihua Wu, Dan Zhu, Yuanyuan Chen, Longhua Chen, Linbo Cai, MD, Cheng Zhou, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 5/2022

Abstract

Purpose

This study aimed to evaluate the clinical features, prognostic factors, and survival outcomes for patients with intracranial nongerminomatous germ cell tumors (NGGCTs), with a particular focus on treatment toxicity for long-term survivors.

Methods

Intracranial NGGCTs treated with platinum-based chemotherapy and craniospinal irradiation (CSI) in our institution were retrospectively analyzed. Hematological complications following sequential chemoradiotherapy as well as height and weight in childhood survivors were evaluated. Plasma growth hormone (GH) concentrations prior to and after radiotherapy were obtained for the comparisons.

Results

A total of 111 intracranial NGGCTs were included. The 3‑year overall survival (OS) and event-free survival (EFS) rates were 83.5% ± 3.9% and 71.0% ± 4.8%, respectively. A combined treatment modality consisting of ≥ 4 cycles of platinum-based chemotherapy and CSI was associated with an improved OS (P = 0.003) and EFS (P < 0.001). Thrombocytopenia of any grade occurred in 35.4% (34/96) of patients, and the threshold age for an increased risk of thrombocytopenia was 14 years (area under the curve AUC = 0.752, P < 0.0001) as derived from receiver operating characteristic (ROC) analysis. Growth impediment was found in 8 of 56 (14%) patients. The age for receiving radiotherapy was found to inversely correlate with height development, revealing a cut-off age of 11.5 years for risking growth impairment (AUC = 0.806, P = 0.004). Consistently, a significant decline in plasma growth hormone after radiotherapy was observed in patients ≤ 11.5 years (P < 0.01) but not patients > 11.5 years. (P > 0.05).

Conclusion

Our study suggested that a combined treatment modality with at least four cycles of chemotherapy and CSI was safe and effective for patients with intracranial NGGCTs. Radiotherapy should be used with caution for patients < 11.5 years due to growth impairment.

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Title: Survival outcomes, hematologic complications and growth impairment after sequential chemoradiotherapy in intracranial NGGCTs: a retrospective study
Authors: Lei Wen
Juan Li
Mingyao Lai
Zhaoming Zhou
Qingjun Hu
Guanhua Deng
Changguo Shan
Ruyu Ai
Hainan Li
Ming Lu
Liang Zhang
Taihua Wu
Dan Zhu
Yuanyuan Chen
Longhua Chen
Linbo Cai, MD
Cheng Zhou, MD, PhD
Publication date: 01-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Thrombocytopenia
Radiotherapy
Cytostatic Therapy
Published in: Strahlentherapie und Onkologie / Issue 5/2022
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01857-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Survival outcomes, hematologic complications and growth impairment after sequential chemoradiotherapy in intracranial NGGCTs: a retrospective study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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