Limited-field radiation for bifocal germinoma

被引:70
作者
Lafay-Cousin, Lucie
Millar, Barbara-Ann
Mabbott, Donald
Spiegler, Brenda
Drake, Jim
Bartels, Ute
Huang, Annie
Bouffet, Eric
机构
[1] Hosp Sick Children, Pediat Brain Tumor Program, Toronto, ON M5G 1X8, Canada
[2] Hosp Sick Children, Dept Psychol, Toronto, ON M5G 1X8, Canada
[3] Hosp Sick Children, Dept Neurosurg, Toronto, ON M5G 1X8, Canada
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2006年 / 65卷 / 02期
关键词
intracranial germinoma; bifocal; focal radiation;
D O I
10.1016/j.ijrobp.2005.12.011
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To report the incidence, characteristics, treatment, and outcomes of bifocal germinomas treated with chemotherapy followed by focal radiation. Methods and Materials: This was a retrospective review. Inclusion criteria included radiologic diagnosis of bifocal germinoma involving the pineal and neurohypophyseal region, no evidence of dissemination on spinal MRI, negative results from cerebrospinal fluid cytologic evaluation, and negative tumor markers. Results: Between 1995 and 2004, 6 patients (5 male, 1 female; median age, 12.8 years) fulfilled the inclusion criteria. All had symptoms of diabetes insipidus at presentation. On MRI, 4 patients had a pineal and suprasellar mass, and 2 had a pineal mass associated with abnormal neurohypophyseal enhancement. All patients received chemotherapy followed by limited-field radiation and achieved complete remission after chemotherapy. The radiation field involved the whole ventricular system (range, 2,400-4,000 cGy) with or without a boost to the primary lesions. All patients remain in complete remission at a median follow-up of 48.1 months (range, 9-73.4 months). Conclusions: This experience suggests that bifocal germinoma can be considered a locoregional rather than a metastatic disease. Chemotherapy and focal radiotherapy might be sufficient to provide excellent outcomes. Staging refinement with new diagnostic tools will likely increase the incidence of the entity. (c) 2006 Elsevier Inc.
引用
收藏
页码:486 / 492
页数:7
相关论文
共 44 条
[1]  
Alapetite C, 2004, NEURO-ONCOLOGY, V6, P449
[2]  
ALAPETITE C, 2003, NEURO-ONCOLOGY, V5, P25
[3]   Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors [J].
Aoyama, H ;
Shirato, H ;
Ikeda, J ;
Fujieda, K ;
Miyasaka, K ;
Sawamura, Y .
JOURNAL OF CLINICAL ONCOLOGY, 2002, 20 (03) :857-865
[4]  
Arita N, 1979, No Shinkei Geka, V7, P465
[5]   Radiation therapy for intracranial germinoma:: Results of the German cooperative prospective trials MAKEI 83/86/89 [J].
Bamberg, M ;
Kortmann, RD ;
Calaminus, G ;
Becker, G ;
Meisner, C ;
Harms, D ;
Göbel, U .
JOURNAL OF CLINICAL ONCOLOGY, 1999, 17 (08) :2585-2592
[6]   An attempt to treat pediatric intracranial αFP and βHCG secreting germ cell tumors with chemotherapy alone.: SFOP experience with 18 cases [J].
Baranzelli, MC ;
Patte, C ;
Bouffet, E ;
Portas, M ;
Mechinaud-Lacroix, F ;
Sariban, E ;
Roche, H ;
Kalifa, C .
JOURNAL OF NEURO-ONCOLOGY, 1998, 37 (03) :229-239
[7]   Combined treatment modality for intracranial germinomas: results of a multicentre SFOP experience [J].
Bouffet, E ;
Baranzelli, MC ;
Patte, C ;
Portas, M ;
Edan, C ;
Chastagner, P ;
Mechinaud-Lacroix, F ;
Kalifa, C .
BRITISH JOURNAL OF CANCER, 1999, 79 (7-8) :1199-1204
[8]   INTRACRANIAL GERM-CELL TUMORS - A COMPREHENSIVE UPDATE OF THE EUROPEAN DATA [J].
CALAMINUS, G ;
BAMBERG, M ;
BARANZELLI, MC ;
BENOIT, Y ;
DIMONTEZEMOLO, LC ;
FOSSATIBELLANI, F ;
JURGENS, H ;
KUHL, HJ ;
LENARD, HG ;
CURTO, ML ;
MANN, JR ;
PATTE, C ;
PEARSON, A ;
PERILONGO, G ;
SCHMIDT, D ;
SCHOBER, R ;
GOBEL, U .
NEUROPEDIATRICS, 1994, 25 (01) :26-32
[9]  
Calaminus G, 2002, MED PEDIATR ONCOL, V39, P227
[10]  
Chuba PJ, 2004, NEURO-ONCOLOGY, V6, P418