Optimal Treatment for Intracranial Germinoma: Can We Lower Radiation Dose Without Chemotherapy?

Sang Hue Yen*, Yi Wei Chen, Pin I. Huang, Tai Tong Wong, Donald Ming Tak Ho, Kai Ping Chang, Muh Lii Liang, Shih Hwa Chiou, Yi Yen Lee, Hsin Hung Chen

*此作品的通信作者

研究成果: Article同行評審

36 引文 斯高帕斯(Scopus)

摘要

Purpose: To review the effectiveness of reduced-dose and restricted-volume radiation-only therapy in the treatment of intracranial germinoma and to assess the feasibility of reducing or eliminating the use of chemotherapy. Methods and Materials: Between January 1996 and March 2007, a retrospective analysis was performed that included 38 patients who received either reduced radiation alone (30 Gy for 26 patients) or reduced radiation with chemotherapy (n = 12 patients). All 38 patients received extended focal (including whole-ventricle) irradiation and were followed up until February 2008. Overall survival (OS) and relapse-free survival (RFS) rates were calculated. Variables associated with survival were evaluated by univariate Cox proportional hazards regression. Results: Median follow-up was 62.4 months (range, 10.1-142.5 months). The total 5-year OS rate was 93.7%. The 5-year OS and RFS rates for patients receiving radiation only were 100% and 96.2%, respectively. The rates for those receiving radiation plus chemotherapy were 83.3 % and 91.7%, respectively (not statistically significant). No predictive factor was significantly associated with the OS or RFS rate. Chemotherapy had no significant effect on survival but was associated with a higher incidence of treatment-related toxicity. Conclusions: A further decrease in the radiation dose to 30 Gy with whole-ventricle irradiation is sufficient to treat selected patients with intracranial germinoma. Wide-field irradiation or chemotherapy should be avoided as these methods are unnecessary. Thus, reduction of the radiation dose to 30 Gy may be feasible, even without chemotherapy.

原文English
頁(從 - 到)980-987
頁數8
期刊International Journal of Radiation Oncology Biology Physics
77
發行號4
DOIs
出版狀態Published - 15 7月 2010

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